Provider Demographics
NPI:1487122008
Name:DUNCAN, HANNAH R (PAC)
Entity type:Individual
Prefix:
First Name:HANNAH
Middle Name:R
Last Name:DUNCAN
Suffix:
Gender:
Credentials:PAC
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:R
Other - Last Name:POOLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3556 MARKET PL W STE 109
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-4339
Mailing Address - Country:US
Mailing Address - Phone:253-534-4640
Mailing Address - Fax:253-534-4679
Practice Address - Street 1:3556 MARKET PL W STE 109
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4339
Practice Address - Country:US
Practice Address - Phone:253-534-4640
Practice Address - Fax:253-534-4679
Is Sole Proprietor?:No
Enumeration Date:2018-11-13
Last Update Date:2025-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA61123176363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2236028Medicaid