Clark Hazel
Social Worker, Clinical in Portland, OR. Individual provider (NPI-1).
NPI number1184238024
StatusActive
Last updated in NPPESDec 17, 2024
Details
- NPI
- 1184238024
- Entity type
- Individual (NPI-1)
- Name
- Clark Hazel
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Sep 8, 2020
- Certification date
- Dec 17, 2024
- Last updated
- Dec 17, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | L14056 | OR | Yes |
Practice location
14600 Nw Cornell RdPortland, OR 97229-5442
Phone 503-645-3581
Mailing address
Po Box 3808Portland, OR 97208-3808
Phone 503-413-3900
Other practice locations
2222 Nw Lovejoy St Ste 606
Portland, OR 97210
Portland, OR 97210
Phone 503-413-5915
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