Provider Demographics
NPI:1871156760
Name:HOUCK, HANNA MARIE
Entity type:Individual
Prefix:
First Name:HANNA
Middle Name:MARIE
Last Name:HOUCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11812 SE 322ND PL
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98092-4811
Mailing Address - Country:US
Mailing Address - Phone:253-740-0368
Mailing Address - Fax:
Practice Address - Street 1:11812 SE 322ND PL
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98092-4811
Practice Address - Country:US
Practice Address - Phone:253-740-0368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-17
Last Update Date:2019-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer