Basic Information
| Provider Information | |||||||||
| NPI: | 1396912614 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HANSEN | ||||||||
| FirstName: | DIANA | ||||||||
| MiddleName: | FRANCO | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1708 YAKIMA AVE STE 300 | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984055309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2533638700 | ||||||||
| FaxNumber: | 3607446270 | ||||||||
| Practice Location | |||||||||
| Address1: | 1708 YAKIMA AVE STE 300 | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984055309 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2533638700 | ||||||||
| FaxNumber: | 3607446270 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2008 | ||||||||
| LastUpdateDate: | 10/05/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/05/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | MD163562 | OR | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0200X | MD163562 | OR | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 207RC0200X | C173563 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | Critical Care Medicine | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program | 207LC0200X | MD61000941 | WA | Y | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine |
ID Information
| ID | Type | State | Issuer | Description | 2026515 | 05 | WA | MEDICAID | 500654540 | 05 | OR | MEDICAID |