Basic Information
Provider Information
NPI: 1073732418
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HANNA
FirstName: RAMY
MiddleName: LEWEZ
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1400 E. KINCAID ST.
Address2: ATTN. CREDENTIALING
City: MOUNT VERNON
State: WA
PostalCode: 982744127
CountryCode: US
TelephoneNumber: 3604282500
FaxNumber: 3604286485
Practice Location
Address1: 307 S. 13TH STREET
Address2: SUITE 300
City: MOUNT VERNON
State: WA
PostalCode: 982744127
CountryCode: US
TelephoneNumber: 3603369757
FaxNumber: 3608145237
Other Information
ProviderEnumerationDate: 04/24/2007
LastUpdateDate: 03/12/2016
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000XMD60015837WAN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207RC0001XMD60015837WAY Allopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology

ID Information
IDTypeStateIssuerDescription
29563001WALABOR & INDUSTRIESOTHER
107373241805WA MEDICAID


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