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Individual

SUSAN JILL HAZEL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP

Contact information

Practice address
15100 BOONES FERRY RD, #700, LAKE OSWEGO, OR 97035-3469
(503) 330-5092
(503) 892-3129
Mailing address
PO BOX 13510, MHPBS, PORTLAND, OR 97213
(503) 249-0181

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
000036739N6
OR

Other

Enumeration date
04/06/2007
Last updated
07/08/2007
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