Individual
NATHAN PAUL HANNEMANN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
7938 CISTENA WAY, PARKER, CO 80134-2717
(208) 416-2932
Mailing address
22100 BOTHELL EVERETT HWY, BOTHELL, WA 98021-8431
(084) 162-9322
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0102208244
VA
2085R0202X
Diagnostic Radiology Physician
34.013624
OH
2085R0202X
Diagnostic Radiology Physician
Primary
CDRH.0067246
CO
Other
Enumeration date
03/20/2013
Last updated
12/05/2023
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