Individual provider Active NPI

Kristina R Hansen

  • Nurse Practitioner
  • Puyallup, WA
National Provider Identifier
1154846335
Registry record updated Aug 8, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP60782628 Issued in WA
Practice address
611 31St Ave SW
Puyallup, WA 98373-3723
Phone
(253) 848-5951
NPI assigned
Aug 8, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 8, 2017

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP60782628 WA Primary

Addresses

Primary practice location

611 31St Ave SW
Puyallup, WA 98373-3723

Mailing address

3908 10TH St SE
Puyallup, WA 98374-2188
Phone (253) 848-5951

Other identifiers 1

IdentifierTypeStateIssuer
0000000000000MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170905000723 WA Practitioner - Nurse Practitioner 6800169350 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Multicare Health SystemGroup PAC ID 7719899897, 2,312 clinicians
South Hill Family Medicine PCGroup PAC ID 8729980396, 67 clinicians

Practice addresses (Care Compare)

325 E Pioneer
Puyallup, WA 98372-3265
Phone (253) 445-8120

4700 Point Fosdick Dr
Gig Harbor, WA 98335-1706

611 31St Ave SW
Suite C
Puyallup, WA 98373-3723
Phone (253) 848-5951

Hospital & facility affiliations

  • Tacoma General Allenmore Hospital Hospital, Tacoma, WA, CCN 500129

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP60782628WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Multicare Health System Current Accepting new patients
Multicare Health System Nurse Practitioner CurrentSince May 10, 2024 Accepting new patients
Multicare Health System CurrentSince May 10, 2024 Accepting new patients
Greater Lakes Mental Health Foundation Inc CurrentSince May 10, 2024 Accepting new patients
South Hill Family Medicine PC CurrentSince Aug 8, 2017 Accepting new patients

Locations

4700 Point Fosdick Dr
Ste 104
Gig Harbor, WA 98335
Phone (253) 459-7590

222 State Ave N
Kent, WA 98030
Phone (253) 372-7680

3908 10th St SE
Puyallup, WA 98374
Phone (253) 848-5951

611 31st Ave SW
Puyallup, WA 98373
Phone (253) 445-7100

611 31st Ave SW
Ste C
Puyallup, WA 98373
Phone (253) 848-5951

9330 59th Ave SW
Tacoma, WA 98499
Phone (253) 581-7020

Interoperability endpoints

  • Direct secure messaging: khansen34972@direct.tecmc.com

Organizations & group practices 5

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1502150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1502150400000",
    "number": "1154846335",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3908 10TH ST SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983742188",
            "telephone_number": "253-848-5951"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 31ST AVE SW",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733723",
            "telephone_number": "253-848-5951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "KRISTINA",
        "middle_name": "R",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-08",
        "last_updated": "2017-08-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP60782628",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0000000000000",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

Verify at the official NPI Registry.