Individual
MARK L HANCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5452
(480) 301-8000
Mailing address
13400 E SHEA BLVD, SCOTTSDALE, AZ 85259-5452
(480) 301-8000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
6664
AZ
363AM0700X
Medical Physician Assistant
PA10004989
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1122HA
REGENCE BLUE SHIELD
—
01
—
206026
LABOR & INDUSTRIES
WA
05
—
8449696
—
WA
Enumeration date
06/28/2006
Last updated
07/21/2022
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