Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0203X | Pediatric Critical Care Doctor | A141614 | CA |
Y | 2080P0203X | Pediatric Critical Care Doctor | MD192330 | OR |
NPI | 1164789012 |
---|---|
Provider Name | Dr. Wendy G Hasson |
First Address | Portland, OR 97227-1623 |
Second Address | Portland, OR 97227-1623 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2012 |
Last Update Date | 13/10/2021 |