Individual
ERIN MARINA HAGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1662 NW 23RD AVE, PORTLAND, OR 97210-2502
(503) 684-8252
Mailing address
1662 NW 23RD AVE, PORTLAND, OR 97210-2502
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
0010-11373
NC
363A00000X
Physician Assistant
0010-11373
NC
363A00000X
Physician Assistant
Primary
PA212971
OR
Other
Enumeration date
08/18/2021
Last updated
10/13/2022
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