TATE J HANSEN

MERIDIAN, ID
NPI1982944617
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363AM0700X Physician Assistant, Medical
(Licence: ID  PA1047)
Enumeration Date2013-02-16
Last Update Date2013-02-16
Business Address
-- TATE J HANSEN PA-C
520 S EAGLE RD STE 1222
MERIDIAN, ID 83642-6351
Phone number: 208-706-2200
Mailing Address
-- TATE J HANSEN PA-C
190 E BANNOCK ST
BOISE, ID 83712-6241
Phone number: 208-381-2222
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