Provider Demographics
NPI:1073940474
Name:GAGNON, MARGARETTE ADELINA (MS, CAGS)
Entity Type:Individual
Prefix:MRS
First Name:MARGARETTE
Middle Name:ADELINA
Last Name:GAGNON
Suffix:
Gender:F
Credentials:MS, CAGS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 WILLIAMS AVE S
Mailing Address - Street 2:APT 305
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-5436
Mailing Address - Country:US
Mailing Address - Phone:978-729-0925
Mailing Address - Fax:
Practice Address - Street 1:110 WILLIAMS AVE S
Practice Address - Street 2:APT 305
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-5436
Practice Address - Country:US
Practice Address - Phone:978-729-0925
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-09-30
Last Update Date:2013-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist