Individual provider · Type 1 NPI

Tate J. Hansen, PA-C

Medical Physician Assistant · Meridian, ID

NPI number 1982944617 Active

Practice location

520 S Eagle Rd, Ste 1222
Meridian, ID 83642-6351

Call (208) 706-2200 Map

Fax (208) 706-2251

Mailing address

190 E Bannock St
Boise, ID 83712-6241

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA1047 (ID)

Medical Physician Assistant: Definition to come...

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About NPI 1982944617

Tate J. Hansen, PA-C's National Provider Identifier is 1982944617, issued on Feb 16, 2013. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Meridian, ID. The record was last updated on Feb 16, 2013.