Individual
DR. EDWARD HAGEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
620 SOUTHEAST 160TH AVE, SUITE D, PORTLAND, OR 97236
(503) 252-9527
(503) 252-4516
Mailing address
620 SOUTHEAST 160TH AVE, PORTLAND, OR 97233
(503) 525-9527
(503) 252-4516
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D3960
OR
Other
Enumeration date
09/21/2006
Last updated
11/04/2008
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