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Individual

HEATHER ELIZABETH HAGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
P.T.

Contact information

Practice address
1108 E 1ST ST, PORT ANGELES, WA 98362-4317
(360) 452-8216
(360) 452-5765
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60385021
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1780023143
WA
01
P01338325
RR MEDICARE
WA
Enumeration date
06/19/2013
Last updated
09/03/2014
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