Individual
AMANDA LOUISE HAGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
310 N SCHOOL ST, NEWBERG, OR 97132-2627
(503) 744-7557
Mailing address
310 N SCHOOL ST, NEWBERG, OR 97132-2627
(503) 744-7557
Taxonomy
Speciality
Code
Description
License number
State
374J00000X
Doula
Primary
THW000111511
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
THW000111511
OREGON HEALTH AUTHORITY THW
OR
Enumeration date
06/24/2024
Last updated
06/24/2024
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