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General NPI Number Information
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NPI Number | 1992348999
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Entity Type | Individual
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Provider Name | PATRICK THOMAS HASSENFRITZ ARNP
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Gender | Male
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Dates
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Enumeration Date | 10/22/2019
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Last Update Date | 09/25/2024
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Provider Practice Location Address
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Address Line | 1625 SE 192ND AVE STE 206
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City | CAMAS
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State | WA
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Zip | 98607-6508
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Country | US
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Telephone | 971-352-4413
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Fax | 971-302-4787
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Provider Business Mailing Address
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Address Line | 7634 N ALBINA AVE
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City | PORTLAND
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State | OR
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Zip | 97217-1308
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Country | US
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Telephone | 503-781-0840
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Fax | 971-302-4787
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 61014092
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License Number State | WA
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