Provider Demographics
NPI:1174916449
Name:HASSEN, STEPHANY (PA-C)
Entity type:Individual
Prefix:
First Name:STEPHANY
Middle Name:
Last Name:HASSEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1082 FAIRVIEW AVE
Mailing Address - Street 2:APARTMENT R3
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-1257
Mailing Address - Country:US
Mailing Address - Phone:567-686-7930
Mailing Address - Fax:
Practice Address - Street 1:904 7TH AVE
Practice Address - Street 2:FLOOR 3
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1132
Practice Address - Country:US
Practice Address - Phone:206-860-4541
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-11
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60539314363AM0700X
COPA.0006220363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical