Individual
AMY HAGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3927 RUCKER AVE, EVERETT, WA 98201-4833
(425) 259-0966
Mailing address
PO BOX 5127, EVERETT, WA 98206-5127
(425) 339-5422
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP61002151
WA
363LF0000X
Family Nurse Practitioner
AP61002151
WA
Other
Enumeration date
09/13/2019
Last updated
12/02/2020
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