Individual
BRYAN M HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DNP, PMHNP
Contact information
Practice address
908 NE 4TH ST STE 100, BEND, OR 97701-4646
(541) 617-7365
Mailing address
685 SE 3RD ST, BEND, OR 97702-1754
(541) 617-7365
Taxonomy
Speciality
Code
Description
License number
State
163WP0809X
Adult Psychiatric/Mental Health Registered Nurse
201042999RN
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201250173NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500689745
—
OR
Enumeration date
10/06/2006
Last updated
10/08/2025
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