Provider Demographics
NPI:1184780751
Name:HAGOSKI, ARLENE MARIE (MSW)
Entity type:Individual
Prefix:
First Name:ARLENE
Middle Name:MARIE
Last Name:HAGOSKI
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 S MASON AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1114
Mailing Address - Country:US
Mailing Address - Phone:253-640-2212
Mailing Address - Fax:
Practice Address - Street 1:33919 9TH AVE S
Practice Address - Street 2:#201
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003
Practice Address - Country:US
Practice Address - Phone:253-927-6616
Practice Address - Fax:253-874-4733
Is Sole Proprietor?:No
Enumeration Date:2006-12-28
Last Update Date:2019-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00006264104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB20329Medicare ID - Type Unspecified