Individual
BRADLEY CHRISTOPHER HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP, FNP
Contact information
Practice address
418 W. MAIN AVENUE, BREWSTER, WA 98812
(509) 689-8900
(509) 689-9031
Mailing address
1390 BIDDLE RD, STE 101, MEDFORD, OR 97504-4169
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
091006932N1
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0293305
L&I
WA
05
—
1184663973
—
WA
01
—
AP30003371
STATE LICENSE
WA
Enumeration date
06/06/2006
Last updated
03/11/2021
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