Individual
MR. DAVID A HAGEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CHEMICAL DEPENDENCY
Contact information
Practice address
1505 KLA-OOK-WA, TAHOLAH, WA 98587-0219
(360) 276-4405
(360) 276-4474
Mailing address
PO BOX 219, TAHOLAH, WA 98587-0219
(360) 276-4405
(360) 276-4474
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP00001894
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1992817
—
WA
Enumeration date
12/18/2008
Last updated
12/18/2008
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