Individual provider Active NPI

Wayne Hansen, NP

  • Nurse Practitioner
  • Yakima, WA
National Provider Identifier
1174551899
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP30006392 Issued in WA
Practice address
110 S 9TH Ave
Yakima, WA 98902-3315
Phone
(508) 575-5061
NPI assigned
Jun 29, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 AP30006392 WA Primary

Addresses

Primary practice location

110 S 9TH Ave
Yakima, WA 98902-3315

Mailing address

9109 Honeycrisp CT
Yakima, WA 98903-9693
Phone (509) 945-9865

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
I20041103000527 WA Practitioner - Nurse Practitioner 8426010299 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP30006392WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Sunnyside Emergency Group a Professional LLC Nurse Practitioner CurrentSince Jun 1, 2014 Accepting new patients
Summitview Urgent Care Inc CurrentSince May 31, 2021 Accepting new patients
Van Meter MD & Associates Past Accepting new patients
Yakima Hma Physician Management LLC Past Accepting new patients
Columbia Valley Emergency Physicians LLC Nurse Practitioner Past Accepting new patients
Washington Em-I Medical Services PC Nurse Practitioner Past Accepting new patients
Washington Em-I Medical Services PC Past Accepting new patients

Locations

1016 Tacoma Ave
Sunnyside, WA 98944
Phone (509) 823-6682

120 S 72nd Ave
Ste 102
Yakima, WA 98908
Phone (509) 902-8856

6101 Summitview Ave
Ste 200
Yakima, WA 98908
Phone (509) 902-8856

Organizations & group practices 7

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.

NPI Registry JSON

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

{
    "created_epoch": "1151539200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1174551899",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9109 HONEYCRISP CT",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989039693",
            "telephone_number": "509-945-9865"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "110 S 9TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023315",
            "telephone_number": "508-575-5061"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "WAYNE",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-29",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30006392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

Verify at the official NPI Registry.