Active NPI
Thomas Harold Hansen, PT
- Pediatric Physical Therapist
- Maple Valley, WA
National Provider Identifier
1407063340
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Physical Therapist
- License
- PT00006617
- Practice address
- 24216 Witte Rd SE
Maple Valley, WA 98038-6827 - Phone
- (425) 413-3583
- NPI assigned
- May 17, 2007
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Physical Therapist | 2251P0200X | PT00006617 | WA | Primary |
Addresses
Primary practice location
24216 Witte Rd SE
Maple Valley, WA 98038-6827
Mailing address
14022 SE 158TH St
Renton, WA 98058-7812
Phone (425) 277-1394
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 8344194 | Medicaid | WA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PT00006617 | WA | MD | Pediatric Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1357257600000",
"number": "1407063340",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14022 SE 158TH ST",
"city": "RENTON",
"state": "WA",
"postal_code": "980587812",
"telephone_number": "425-277-1394"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24216 WITTE RD SE",
"city": "MAPLE VALLEY",
"state": "WA",
"postal_code": "980386827",
"telephone_number": "425-413-3583"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HANSEN",
"first_name": "THOMAS",
"middle_name": "HAROLD",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2007-05-17",
"last_updated": "2013-01-04",
"status": "A"
},
"taxonomies": [
{
"code": "2251P0200X",
"taxonomy_group": "",
"desc": "Physical Therapist, Pediatrics",
"state": "WA",
"license": "PT00006617",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "8344194",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Maple Valley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.