Individual
MARA HAZELTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
62 W 7TH AVE STE 320, SPOKANE, WA 99204-2321
(509) 381-6505
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
(509) 227-7070
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD61263356
WA
Other
Enumeration date
03/21/2019
Last updated
07/19/2024
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