Individual
MR. JEROME HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
1660 S COLUMBIAN WAY, SEATTLE, WA 98108-1532
(206) 764-2017
(206) 768-5227
Mailing address
5407 SW GENESEE ST, SEATTLE, WA 98116-3929
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
020701 RC00018843
WA
Other
Enumeration date
08/30/2006
Last updated
07/08/2007
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