Provider Demographics
NPI:1679750012
Name:HAU, DERRICK (DC)
Entity type:Individual
Prefix:
First Name:DERRICK
Middle Name:
Last Name:HAU
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 FRANKLIN ST
Mailing Address - Street 2:STE 204
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98660-3355
Mailing Address - Country:US
Mailing Address - Phone:503-545-6060
Mailing Address - Fax:
Practice Address - Street 1:800 FRANKLIN ST
Practice Address - Street 2:STE 204
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98660-3355
Practice Address - Country:US
Practice Address - Phone:503-545-6060
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-29
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00034415111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8852915Medicare PIN