Provider Demographics
NPI:1649454166
Name:HAGUEWOOD, CHRIS SAMUEL
Entity type:Individual
Prefix:
First Name:CHRIS
Middle Name:SAMUEL
Last Name:HAGUEWOOD
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1918 EVERETT AVE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-3607
Mailing Address - Country:US
Mailing Address - Phone:425-257-2101
Mailing Address - Fax:
Practice Address - Street 1:1918 EVERETT AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3607
Practice Address - Country:US
Practice Address - Phone:425-257-2101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00059675101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health