Provider Demographics
NPI:1487695714
Name:HAGEN, JOANNA MARIE (ARNP)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:MARIE
Last Name:HAGEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:JOANNA
Other - Middle Name:MARIE
Other - Last Name:NEWTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:7713 CENTER BLVD SE STE 160
Mailing Address - Street 2:
Mailing Address - City:SNOQUALMIE
Mailing Address - State:WA
Mailing Address - Zip Code:98065-6309
Mailing Address - Country:US
Mailing Address - Phone:425-292-3347
Mailing Address - Fax:425-738-3020
Practice Address - Street 1:7713 CENTER BLVD SE STE 160
Practice Address - Street 2:
Practice Address - City:SNOQUALMIE
Practice Address - State:WA
Practice Address - Zip Code:98065-6309
Practice Address - Country:US
Practice Address - Phone:425-292-3347
Practice Address - Fax:425-738-3020
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006257207Q00000X, 363LG0600X, 363A00000X, 363LW0102X, 363LP0200X, 363LP2300X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
No363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAP97765Medicare UPIN
G8864750Medicare PIN