Provider Demographics
NPI:1396117438
Name:HAGEN, JENSON JAMES (ND)
Entity type:Individual
Prefix:DR
First Name:JENSON
Middle Name:JAMES
Last Name:HAGEN
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12407 235TH PL NE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:WA
Mailing Address - Zip Code:98053-5616
Mailing Address - Country:US
Mailing Address - Phone:303-356-8284
Mailing Address - Fax:
Practice Address - Street 1:12407 235TH PL NE
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98053-5616
Practice Address - Country:US
Practice Address - Phone:303-356-8284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-28
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath