Active NPI
Ma Hazel Lyn Gutierrez Gavino, MD
- Family Medicine Physician
- Kennewick, WA
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD.MD.60114725
- Practice address
- 6351 W Rio Grande Ave
Kennewick, WA 99336-7634 - Phone
- (509) 543-9280
- NPI assigned
- Sep 11, 2007
- 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 |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD.MD.60114725 | WA | Primary |
| Family Medicine Physician | 207Q00000X | 4301090727 | MI |
Addresses
Primary practice location
6351 W Rio Grande Ave
Kennewick, WA 99336-7634
Mailing address
PO Box 190
Toppenish, WA 98948-0190
Phone (509) 865-2395
Other practice location 1
721 S Auburn St
Kennewick, WA 99336-5665
Phone (509) 737-1878
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- Other, 2004
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Telehealth
- Offers telehealth services
- Group practices
Practice addresses (Care Compare)
7211 W Deschutes Ave
Suite B
Kennewick, WA 99336-7715
Phone (509) 221-6930
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4301090727 | MI | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| RCCH Trios Health LLC | Family Medicine | Current | Accepting new patients |
| Kennewick Public Hospital District | Past | Accepting new patients |
Locations
900 S Auburn St
Kennewick, WA 99336
Phone (509) 586-5111
7211 W Deschutes Ave
Ste B
Kennewick, WA 99336
Phone (509) 221-6930
216 W 10th Ave
Ste 204
Kennewick, WA 99336
Phone (509) 221-5520
Interoperability endpoints
- ma.hazel.lyn.gavino.1@18485.direct.athenahealth.com
Organizations & group practices 2
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.
-
dba KGH Physician Clinics
- Multi-Specialty Clinic/Center
- Kennewick, WA
- NPI 1235257262
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Columbia River Home Health
- Home Health Agency
- Kennewick, WA
- NPI 1699263079
-
- General Acute Care Hospital
- Richland, WA
- NPI 1972507580
-
- General Acute Care Hospital
- Kennewick, WA
- NPI 1578058137
-
dba Tri Cities Home Health
- Home Health Agency
- Kennewick, WA
- NPI 1679547244
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1189468800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1786060800000",
"number": "1679768865",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 190",
"city": "TOPPENISH",
"state": "WA",
"postal_code": "989480190",
"telephone_number": "509-865-2395",
"fax_number": "509-865-0757"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6351 W RIO GRANDE AVE",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993367634",
"telephone_number": "509-543-9280"
}
],
"practiceLocations": [
{
"address_1": "721 S Auburn St",
"address_purpose": "LOCATION",
"city": "Kennewick",
"state": "WA",
"postal_code": "993365665",
"country_code": "US",
"telephone_number": "509-737-1878",
"fax_number": "509-737-1879",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GAVINO",
"first_name": "MA HAZEL LYN",
"middle_name": "GUTIERREZ",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-09-11",
"last_updated": "2026-08-07",
"certification_date": "2026-08-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WA",
"license": "MD.MD.60114725",
"primary": true
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "MI",
"license": "4301090727",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennewick, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 7, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.