Hagen, Nicholas D

Hagen, Nicholas D is an individual health care provider with primary practice located at 1160 Sw Simpson Ave Ste 200, Bend OR 97702. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports, which is considered as his primary health care specialty. Hagen, Nicholas D can be contacted via phone (541) 322-9045.

Contact Information

Primary practice address
1160 Sw Simpson Ave Ste 200 Bend OR 97702
Phone: (541) 322-9045
Fax: (541) 322-9044
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Sports 2251S0007X 6856 Oregon

Profile Details

NPI number 1609104496
LBN Legal business name Hagen, Nicholas D
Credentials DPT, SCS, CSCS
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 7th, 2009
Last updated Mar 3rd, 2016 - about 8 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609104496 NPPES
Oregon MEDICAID 500695874

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