Provider Demographics
NPI:1003236159
Name:HAGEN, DEBRA
Entity Type:Individual
Prefix:MRS
First Name:DEBRA
Middle Name:
Last Name:HAGEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18513 126TH ST SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-8639
Mailing Address - Country:US
Mailing Address - Phone:206-650-5936
Mailing Address - Fax:
Practice Address - Street 1:18513 126TH ST SE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-8639
Practice Address - Country:US
Practice Address - Phone:206-650-5936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-16
Last Update Date:2014-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula