Provider Demographics
NPI:1902274251
Name:CARLSEN, HANNAH SCHONAU (DPT)
Entity Type:Individual
Prefix:
First Name:HANNAH
Middle Name:SCHONAU
Last Name:CARLSEN
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:HANNAH
Other - Middle Name:
Other - Last Name:SCHONAU-TAYLOR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DPT
Mailing Address - Street 1:121 NW GREENWOOD AVE
Mailing Address - Street 2:STE 101
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97703-2079
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:121 NW GREENWOOD AVE STE 101
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-2079
Practice Address - Country:US
Practice Address - Phone:541-388-2681
Practice Address - Fax:541-388-9236
Is Sole Proprietor?:No
Enumeration Date:2015-09-03
Last Update Date:2022-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR61051225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist