Individual
MRS. JESSICA ANN HAZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, RD, IBCLC
Contact information
Practice address
2502 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3965
(360) 397-8459
(360) 397-4367
Mailing address
2502 E 4TH PLAIN BLVD, VANCOUVER, WA 98661-3965
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI60841895
WA
133V00000X
Registered Dietitian
LD-D-10190313
OR
133VN1004X
Pediatric Nutrition Registered Dietitian
LD-D-10190313
OR
174N00000X
Lactation Consultant (Non-RN)
LD-D-10190313
OR
174N00000X
Lactation Consultant (Non-RN)
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Other
Enumeration date
04/01/2018
Last updated
08/09/2022
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