Individual
RACHELLE HAZEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10564 SE WASHINGTON ST, PORTLAND, OR 97216-2809
(032) 289-2295
(032) 289-5585
Mailing address
3910 SE STARK ST, PORTLAND, OR 97214-3241
(503) 802-0598
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
172V00000X
Community Health Worker
—
—
Other
Enumeration date
09/09/2014
Last updated
12/03/2018
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