1174647838 NPI number — PREGNANCY AID OF SNOHOMISH COUNTY

Table of content: GEORGE KRISTIAN HANSON MD (NPI 1487618583)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174647838 NPI number — PREGNANCY AID OF SNOHOMISH COUNTY

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
PREGNANCY AID OF SNOHOMISH COUNTY
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1174647838
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/17/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1819 100TH PL SE STE B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EVERETT
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98208-3864
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-316-8929
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1819 100TH PL SE STE B
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
EVERETT
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98208-3864
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-316-8929
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/19/2007

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
MCGINTY
Authorized Official First Name:
CAROLYN
Authorized Official Middle Name:
Authorized Official Title or Position:
WIC PROGRAM MANAGER
Authorized Official Telephone Number:
425-316-8939

Provider Taxonomy Codes

  • Taxonomy code: 251V00000X , with the licence number:  601141841 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)