NPI 1457976045
Tyson Hanson
Practice location
- Address
- 1496 N 1070 E, Sheley, ID 83274
- Phone
- (208) 521-1837
- Mailing address
- 315 Wind River Dr, Shelley, ID 83274-2101
Registered specialties
Child Intellectual and/or Developmental Disabilities Respite Care
Primary
Registry record
- NPI
- 1457976045
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 10 Jun 2020
- Record last updated
- 10 Jun 2020
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.