Active NPI
Rachelle Hazen
- Addiction (Substance Use Disorder) Counselor
- Portland, OR
National Provider Identifier
1598166589
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- Practice address
- 10564 SE Washington St
Portland, OR 97216-2809 - Phone
- (032) 289-2295
- Fax
- (032) 289-5585
- NPI assigned
- Sep 9, 2014
- Last updated
- Dec 3, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | NU | Primary | |
| Community Health Worker | 172V00000X | NU |
Addresses
Primary practice location
10564 SE Washington St
Portland, OR 97216-2809
Mailing address
3910 SE Stark St
Portland, OR 97214-3241
Phone (503) 802-0598
Other practice location 1
11211 SE 82nd Ave
Suite 0
Happy Valley, OR 97086-7624
Phone (503) 722-6200
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Volunteers of America Inc. | Past | Accepting new patients | |
| Volunteers of America | Past | Accepting new patients | |
| Volunteers of America Oregon | Past | Accepting new patients |
Organizations & group practices 3
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Case Management Agency
- Portland, OR
- NPI 1558897710
-
dba Volunteers Of America Of Oregon Inc.
- Contractor
- Portland, OR
- NPI 1376611418
-
- Specialist
- Portland, OR
- NPI 1801298724
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410220800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543795200000",
"number": "1598166589",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3910 SE STARK ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972143241",
"telephone_number": "503-802-0598"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10564 SE WASHINGTON ST",
"city": "PORTLAND",
"state": "OR",
"postal_code": "972162809",
"telephone_number": "032-289-2295",
"fax_number": "032-289-5585"
}
],
"practiceLocations": [
{
"address_1": "11211 SE 82nd Ave",
"address_2": "Suite 0",
"address_purpose": "LOCATION",
"city": "Happy Valley",
"state": "OR",
"postal_code": "970867624",
"country_code": "US",
"telephone_number": "503-722-6200",
"fax_number": "503-722-6545",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HAZEN",
"first_name": "RACHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-09",
"last_updated": "2018-12-03",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NU",
"license": null,
"primary": true
},
{
"code": "172V00000X",
"taxonomy_group": "",
"desc": "Community Health Worker",
"state": "NU",
"license": null,
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 3, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.