Hansen, Jody Eric

Hansen, Jody Eric is an individual health care provider with primary practice located at 2710 Meridian St , Bellingham WA 98225-2411. He recently has only one registered license in Dental Providers / Denturist, which is considered as his primary health care specialty. Hansen, Jody Eric can be contacted via phone (360) 676-1499.

Contact Information

Primary practice address
2710 Meridian St Bellingham WA 98225-2411
Phone: (360) 676-1499
Fax: (360) 738-2281
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Denturist 122400000X DN00000002 Washington

Profile Details

NPI number 1265642854
LBN Legal business name Hansen, Jody Eric
Credentials L.D.
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2007
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1265642854 NPPES
Washington Other DN00000002 WA DENTURIST LICENSE #
Washington MEDICAID 5020052 WA DENTURIST LICENSE #

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