| Provider / Organization | NPI | Date Certified |
|---|---|---|
| SHANNON GABRIELLE HANSEN | 1417124538 | 2024-11-08 |
Shannon Gabrielle Bradley [F] graduated in 2008 from University Of Minnesota Medical School and primarily specializes in Family Medicine.
Shannon Gabrielle Hansen is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1417124538. Registration indicates Shannon Gabrielle Hansen is a provider of access to adult/geriatric primary care providers services with a specialization in Allopathic & Osteopathic Physicians, Family Medicine Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Family Medicine) (Allopathic & Osteopathic Physicians, Family Medicine) (Family Medicine, ) (Primary Care/Family Planning/APRN/PA, ) (Family Medicine, Allopathic & Osteopathic Physicians) Access to Adult/Geriatric Primary Care Providers (Allopathic & Osteopathic Physicians, Family Medicine) Access to Pediatric Primary Care Providers (Allopathic & Osteopathic Physicians, Family Medicine) (Allopathic & Osteopathic Physicians, Family Medicine) (Family Medicine, ) (Primary Care/Family Planning/APRN/PA, ) (Family Medicine, Allopathic & Osteopathic Physicians) (Allopathic & Osteopathic Physicians, Emergency Medicine) (Emergency Medicine: Emergency Medical Services, ) (All Other Specialties & Provider Types, ) (Emergency Medicine Emergency Medical Services, Allopathic & Osteopathic Physicians) (Emergency Medicine, )
| PECOS ID | 648316844 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Shannon Gabrielle Hansen M.D. |
| Other Provider Name | Shannon Gabrielle Bradley |
| Practice Office Address | 315 MARTIN LUTHER KING JR WAY TACOMA, WA US |
| Practice Office Telephone | 2534031000 |
| Mailing Address | PO BOX 5299 MS: 820-5-PCO TACOMA, WA 984150299 US |
| Address | City / State | Phone / Fax |
|---|---|---|
| 330 N 8th Ave E | Duluth, MN 558052024 | 2187231112 / 2185299120 |
| Direct Messaging Address [] | [email protected] | Direct Franciscan Medical Group |
| Code | Practice | License No State |
|---|---|---|
| 207Q00000X | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians Family MedicineAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Family Medicine Allopathic & Osteopathic Physicians Family Medicine Family Medicine Primary Care/Family Planning/APRN/PA Family Medicine Allopathic & Osteopathic Physicians | MD60293423
WA |
| 207Q00000X | Access to Adult/Geriatric Primary Care Providers Allopathic & Osteopathic Physicians Family MedicineAccess to Pediatric Primary Care Providers Allopathic & Osteopathic Physicians Family Medicine Allopathic & Osteopathic Physicians Family Medicine Family Medicine Primary Care/Family Planning/APRN/PA Family Medicine Allopathic & Osteopathic Physicians | 51866
MN |
| 207PE0004X PRIMARY | Allopathic & Osteopathic Physicians Emergency Medicine Emergency Medicine: Emergency Medical Services All Other Specialties & Provider Types Emergency Medicine Emergency Medical Services Allopathic & Osteopathic Physicians Emergency Medicine | MD60293423
WA |
| 2020161 | MEDICAID | WA | |
| P00767187 | OTHER | MEDICARE RAILRO | |
| 01-37427 | OTHER | MEDICA |