Individual
SHELBY L HAZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, LD
Contact information
Practice address
1235 SE DIVISION ST, PORTLAND, OR 97202-1099
(360) 726-4141
Mailing address
11744 SW 61ST AVE, PORTLAND, OR 97219-7017
(503) 910-1409
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
—
—
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
11/13/2017
Last updated
03/24/2023
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