Individual ProviderTara Dawn HansenMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address10004 Glacier Hwy, Juneau, AK 99801-8560(907) 500-4888PECOS EnrollmentBased on the most recent information from CMS, provider Tara Dawn Hansen does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 11:47 AM.Profile DetailsProvider ID1205364619Provider TypeIndividualFull NameHansen, Tara DawnCredentialLMTGenderFemaleSole ProprietorYesEnumeration Date5/30/2017Last Updated7/21/2022Contact InformationPractice LocationPractice Address10004 Glacier Hwy, Juneau, AK 99801-8560Phone(907) 500-4888FaxUnlisted FaxMailing LocationMailing Address10004 Glacier Hwy, Juneau, AK 99801Phone(907) 500-4888FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode225700000XPrimaryDescriptionMassage TherapistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicense101560AlaskaProvider IdentifiersIDDescriptionIssuerID101560DescriptionOtherIssuerLINCENSED MASSAGE THERAPYAlaska