Provider Demographics
NPI:1679765358
Name:HANSEN, SHERYL MARIE (DC)
Entity type:Individual
Prefix:
First Name:SHERYL
Middle Name:MARIE
Last Name:HANSEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13412 PACIFIC AVE S
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-4866
Mailing Address - Country:US
Mailing Address - Phone:253-531-5242
Mailing Address - Fax:253-537-7293
Practice Address - Street 1:13412 PACIFIC AVE S
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-4866
Practice Address - Country:US
Practice Address - Phone:253-531-5242
Practice Address - Fax:253-537-7293
Is Sole Proprietor?:No
Enumeration Date:2007-08-15
Last Update Date:2008-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001966111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor