Provider Demographics
NPI:1538974639
Name:HAGG, SABRINA NICOLE (DC)
Entity type:Individual
Prefix:
First Name:SABRINA
Middle Name:NICOLE
Last Name:HAGG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1716 SE RAMONA ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-4963
Mailing Address - Country:US
Mailing Address - Phone:425-638-9896
Mailing Address - Fax:
Practice Address - Street 1:905 SE ANKENY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1349
Practice Address - Country:US
Practice Address - Phone:971-236-7610
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-07
Last Update Date:2025-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6434111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor