Individual provider · Type 1 NPI

Evan Mikel Hagen, ATC, PTA

Physical Therapy Assistant · Lacey, WA

NPI number 1356693634 Active

Practice location

2610 Greenlawn St SE
Lacey, WA 98503-3736

Specialties and licenses

Taxonomy	Code	License
Physical Therapy Assistant Primary	225200000X	P1 60167096 (WA)
Athletic Trainer	2255A2300X	A1 60030239 (WA)

Physical Therapy Assistant: (1)Physical therapist assistants are skilled health care providers who are graduates of a physical therapist assistant associate degree program accredited by an agency recognized by the Secretary of the U.S. Department of Education or Council on Postsecondary Accreditation, who assists the physical therapist in providing physical therapy. The supervising physical therapist is directly responsible for the actions of …

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About NPI 1356693634

Evan Mikel Hagen, ATC, PTA's National Provider Identifier is 1356693634, issued on Oct 10, 2012. The primary taxonomy on file is Physical Therapy Assistant (225200000X), and the practice location is in Lacey, WA. The record was last updated on Oct 10, 2012.