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Individual

JAMES J HASENAUER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
545 NE 47TH AVE STE 215, PORTLAND, OR 97213-2237
(503) 731-2900
Mailing address
PO BOX 4000-21, PORTLAND, OR 97213
(949) 263-8620
(949) 263-1639

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
A89001
CA
2085R0202X
Diagnostic Radiology Physician
Primary
MD27906
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00A890010
BLUE SHIELD
CA
05
00A890010
CA
05
247718
CA
01
840126029
REGENCE BS BC
OR
05
8501595
WA
Enumeration date
05/11/2006
Last updated
05/13/2008
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