Provider Demographics
NPI:1992023147
Name:HAGLUND, KRISTEN D'ANNE (ND)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:D'ANNE
Last Name:HAGLUND
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11825 SW GREENBURG RD
Mailing Address - Street 2:SUITE A2
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-6460
Mailing Address - Country:US
Mailing Address - Phone:503-443-2332
Mailing Address - Fax:503-443-2142
Practice Address - Street 1:11825 SW GREENBURG RD
Practice Address - Street 2:SUITE A2
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-6460
Practice Address - Country:US
Practice Address - Phone:503-443-2332
Practice Address - Fax:503-443-2142
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-12
Last Update Date:2010-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1735175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath