Basic Information
| Provider Information | |||||||||
| NPI: | 1477620524 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAUGEN | ||||||||
| FirstName: | PAULINE | ||||||||
| MiddleName: | LOIS | ||||||||
| NamePrefix: | MISS | ||||||||
| NameSuffix: | |||||||||
| Credential: | DC | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
| OtherLastName: | ARNILL | ||||||||
| OtherFirstName: | PAULINE | ||||||||
| OtherMiddleName: | LOIS | ||||||||
| OtherNamePrefix: | MS. | ||||||||
| OtherNameSuffix: | |||||||||
| OtherCredential: | DC | ||||||||
| OtherLastNameType: | 5 | ||||||||
| Mailing Information | |||||||||
| Address1: | 227 BELLEVUE WAY NE | ||||||||
| Address2: | #294 | ||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980045721 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4258308367 | ||||||||
| FaxNumber: | 4254621742 | ||||||||
| Practice Location | |||||||||
| Address1: | 1370 116TH AVE NE | ||||||||
| Address2: | #206 | ||||||||
| City: | BELLEVUE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980043825 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4258308367 | ||||||||
| FaxNumber: | 4254621742 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2006 | ||||||||
| LastUpdateDate: | 10/14/2009 | ||||||||
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| NPIReactivationDate: | |||||||||
| ProviderGenderCode: | F | ||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
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| AuthorizedOfficialNameSuffix: | |||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | 5155 | CO | Y | Chiropractic Providers | Chiropractor |
No ID Information.