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General NPI Number Information
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NPI Number | 1689899098
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Entity Type | Individual
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Provider Name | THOMAS HARDY LAGEN MD
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Gender | Male
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1310 S UNION AVE
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City | TACOMA
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State | WA
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Zip | 98405-1907
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Country | US
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Telephone | 253-363-6246
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Fax | 253-514-6829
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Provider Business Mailing Address
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Address Line | PO BOX 1815
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City | GIG HARBOR
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State | WA
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Zip | 98335-3815
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Country | US
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Telephone | 253-363-6246
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Fax | 253-514-6829
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | MD00040243
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License Number State | WA
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