NPI 1285300475 · live from the CMS NPI Registry
Erin Marina Hagen, PA-C
Physician Assistant in Portland, OR. National Provider Identifier 1285300475, active.
NPI record
| NPI | 1285300475 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 1662 Nw 23rd Ave, Portland, OR 97210 |
| Practice phone | 503-684-8252 |
| Enumerated | August 18, 2021 |
| Last updated | October 13, 2022 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dermatology | 207N00000X | 0010-11373 (NC) |
| Physician Assistant | 363A00000X | 0010-11373 (NC) |
| Physician Assistant primary | 363A00000X | PA212971 (OR) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.