Provider Demographics
NPI:1871082974
Name:QUENGA, HANSON AND PURDUE, P.S., INC.
Entity type:Organization
Organization Name:QUENGA, HANSON AND PURDUE, P.S., INC.
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:LARA
Authorized Official - Middle Name:ANNE
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-858-3332
Mailing Address - Street 1:7306 STINSON AVE
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98335-1140
Mailing Address - Country:US
Mailing Address - Phone:253-858-3332
Mailing Address - Fax:253-858-3327
Practice Address - Street 1:4606 BRIDGEPORT WAY W STE C
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4200
Practice Address - Country:US
Practice Address - Phone:253-565-3551
Practice Address - Fax:253-565-4535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-03
Last Update Date:2018-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty