Individual
MR. BRIAN DONALD HAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
B.S. C.O.T.A. L
Contact information
Practice address
14145 SW 105TH AVE, TIGARD, OR 97224-4808
(503) 961-4942
Mailing address
10974 SW DURHAM RD APT 57, TIGARD, OR 97224-4350
(503) 961-4942
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
1008623
OR
224Z00000X
Occupational Therapy Assistant
OCOOOO1012
WA
Other
Enumeration date
07/03/2007
Last updated
07/08/2007
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