1609205186 NPI number — CAROLINE HANSCHEN CNM, WHNP-BC, RNC-OB

Table of content: CAROLINE HANSCHEN CNM, WHNP-BC, RNC-OB (NPI 1609205186)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1609205186 NPI number — CAROLINE HANSCHEN CNM, WHNP-BC, RNC-OB

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HANSCHEN
Provider First Name:
CAROLINE
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
CNM, WHNP-BC, RNC-OB
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
GOURLEY
Provider Other First Name:
CAROLINE
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1609205186
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/29/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9040 JACKSON AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JBLM
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98431
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
253-968-1406
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
9040 JACKSON AVE DEPT OBGYN
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TACOMA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98431-4210
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
253-968-3751
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/05/2013

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: 163WX0003X , with the licence number:  797616 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WX0003X , with the licence number: RN00150510 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163WX0003X , with the licence number: 156445 , registered in the state of TN ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LW0102X , with the licence number: 23848 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367A00000X , with the licence number: 2077 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 367A00000X , with the licence number: AP60417502 , 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)

  • Identifier: 2139984 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".