Individual provider Active NPI

Kendra L Hansen, PA-C

  • Obstetrics & Gynecology Physician
  • Olympia, WA
National Provider Identifier
1790774545
Registry record updated Jul 13, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
PA10003920 Issued in WA
Practice address
3920 Capitol Mall Dr SW
Suite 400
Olympia, WA 98502-8700
Phone
(360) 705-1259
Fax
(360) 705-2757
NPI assigned
Oct 14, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 13, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X PA10003920 WA Primary

Addresses

Primary practice location

3920 Capitol Mall Dr SW
Suite 400
Olympia, WA 98502-8700

Mailing address

3920 Capitol Mall Dr SW
Suite 400
Olympia, WA 98502-8700
Phone (360) 705-1259

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100924000486 WA Practitioner - Physician Assistant 9234255407

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

NPI Registry JSON

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

{
    "created_epoch": "1129248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1790774545",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3920 CAPITOL MALL DR SW",
            "address_2": "SUITE 400",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028700",
            "telephone_number": "360-705-1259",
            "fax_number": "360-705-2757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3920 CAPITOL MALL DR SW",
            "address_2": "SUITE 400",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985028700",
            "telephone_number": "360-705-1259",
            "fax_number": "360-705-2757"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSEN",
        "first_name": "KENDRA",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-14",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "WA",
            "license": "PA10003920",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.