Provider Demographics
NPI:1043053952
Name:HAZELTON, MARIA DEL ROSARIO
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:DEL ROSARIO
Last Name:HAZELTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6132 80TH ST NE
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98270-3334
Mailing Address - Country:US
Mailing Address - Phone:425-442-2361
Mailing Address - Fax:
Practice Address - Street 1:525 E COLLEGE WAY STE H
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-5571
Practice Address - Country:US
Practice Address - Phone:425-442-2361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-18
Last Update Date:2024-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA605021252171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes171R00000XOther Service ProvidersInterpreterGroup - Single Specialty