Provider Demographics
NPI:1386897536
Name:HAGEN, JANA (ND)
Entity type:Individual
Prefix:DR
First Name:JANA
Middle Name:
Last Name:HAGEN
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2520 241ST ST SE
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98021-6519
Mailing Address - Country:US
Mailing Address - Phone:206-734-4779
Mailing Address - Fax:425-491-5390
Practice Address - Street 1:2324 EASTLAKE AVE E
Practice Address - Street 2:SUITE 510
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3345
Practice Address - Country:US
Practice Address - Phone:206-734-4779
Practice Address - Fax:425-491-5390
Is Sole Proprietor?:No
Enumeration Date:2008-10-31
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT 00001586175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath