Individual
MIE HAGIWARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
4011 TALBOT RD S, SUITE 300, RENTON, WA 98055-5773
(425) 656-5060
(425) 656-5047
Mailing address
805 MADISON ST, SUITE 901, SEATTLE, WA 98104-1172
(206) 264-8100
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA60509719
WA
363AM0700X
Medical Physician Assistant
PA60509719
WA
363AS0400X
Surgical Physician Assistant
Primary
PA60509719
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2041661
—
WA
Enumeration date
12/03/2014
Last updated
01/31/2017
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