Individual
DWANE LYLE HANSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1235 WAVERLY DR SE, ALBANY, OR 97322-6944
(541) 928-8668
Mailing address
PO BOX 61402, 1704 DAVIS AVE, VANCOUVER, WA 98666-1402
(503) 516-9946
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
24695
TX
183500000X
Pharmacist
Primary
6611
OR
183500000X
Pharmacist
PH60060820
WA
183500000X
Pharmacist
S017817
AZ
Other
Enumeration date
04/05/2011
Last updated
04/05/2011
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