1174801674 NPI number — MS. HELEN HYE-JUNG HANSEN PSYD

Table of content: MS. HELEN HYE-JUNG HANSEN PSYD (NPI 1174801674)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1174801674 NPI number — MS. HELEN HYE-JUNG HANSEN PSYD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HANSEN
Provider First Name:
HELEN
Provider Middle Name:
HYE-JUNG
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
PSYD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
CHOI
Provider Other First Name:
HELEN
Provider Other Middle Name:
HYE-JUNG
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
M.A.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1174801674
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 25608
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SALT LAKE CITY
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84125-0608
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
206-320-4476
Provider Business Mailing Address Fax Number:
206-568-7043

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
751 NE BLAKELY DR STE 5010
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ISSAQUAH
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98029-6201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-394-0700
Provider Business Practice Location Address Fax Number:
425-394-0701
Provider Enumeration Date:
08/01/2011

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 103TC0700X , with the licence number: PY60531674 , 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)