Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Evan Mikel Hagen, ATC, PTA

Individual provider Physical Therapy Assistant · NPI 1356693634

Evan Mikel Hagen, ATC, PTA is a Physical Therapy Assistant in Lacey, Washington. Licensed in Washington. Registered with an NPI since 2012.

Licensed in
WA
In the registry since
2012
Specialties on file
2
What do these letters mean?
ATC — Certified Athletic Trainer
Prevents and treats sport and activity injuries.
PTA — Physical Therapist Assistant
Delivers treatment under a physical therapist's direction.

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Practice location Address checks out

2610 Greenlawn St SE
Lacey, WA 98503-3736
Phone: (360) 701-4573
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapy Assistant (primary) Taxonomy 225200000X · Licence P1 60167096 (WA)
Athletic Trainer Taxonomy 2255A2300X · Licence A1 60030239 (WA)

Record details

NPI number1356693634
Entity typeIndividual (Type 1)
GenderMale
Credentials ATC , PTA
Sole proprietorNo
NPI enumeratedOctober 10, 2012
Last updated in NPPESOctober 10, 2012

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