Provider Demographics
NPI:1750594164
Name:HASSING, CHRISTINE MARIE
Entity type:Individual
Prefix:MISS
First Name:CHRISTINE
Middle Name:MARIE
Last Name:HASSING
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:CHRISTINE
Other - Middle Name:MARIE
Other - Last Name:HASSING
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 532
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:OR
Mailing Address - Zip Code:97027
Mailing Address - Country:US
Mailing Address - Phone:503-656-3126
Mailing Address - Fax:
Practice Address - Street 1:10102 NE GLISAN
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97220
Practice Address - Country:US
Practice Address - Phone:503-257-5959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA1779126800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant