Amy Hagen

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

AP61002151 Issued in WA

Practice address

3927 Rucker Ave
Everett, WA 98201-4833

Phone

(425) 259-0966

NPI assigned

Sep 13, 2019

Last updated

Dec 2, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in WA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Seahurst Chiropractic Clinic Inc.

  • Chiropractor
  • Burien, WA
  • NPI 1316146319
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1568332800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1912557612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 5127",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982065127",
            "telephone_number": "425-339-5422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3927 RUCKER AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014833",
            "telephone_number": "425-259-0966"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGEN",
        "first_name": "AMY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-13",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP61002151",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WA",
            "license": "AP61002151",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lawrence R Haft, MD
• Diana Hafzallla, LMHCA
• Kevin Michael Hagan, CDP
• Travis Hagan, RN
• Emma Hageman
• Rachael Hager
• Brittany S Haggard
• David Haggen, LMP
• Haggen, Inc (Haggen Food & Pharmacy, TOP Food & Drug)
• Colin Michael Haggerty Jr., M. ED, BCBA, LBA

• Nurse Practitioner in Everett, WA
• Providers in Everett, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.