Provider Demographics
| NPI: | 1144011958 |
|---|---|
| Name: | HAZELNUT HEALTH PLLC |
| Entity type: | Organization |
| Organization Name: | HAZELNUT HEALTH PLLC |
| Other - Org Name: | <UNAVAIL> |
| Other - Org Type: | |
| Authorized Official - Title/Position: | OWNER |
| Authorized Official - Prefix: | |
| Authorized Official - First Name: | MARLENE |
| Authorized Official - Middle Name: | J |
| Authorized Official - Last Name: | HILLYER |
| Authorized Official - Suffix: | |
| Authorized Official - Credentials: | |
| Authorized Official - Phone: | 360-209-4050 |
| Mailing Address - Street 1: | 8301B 5TH AVE NE |
| Mailing Address - Street 2: | |
| Mailing Address - City: | SEATTLE |
| Mailing Address - State: | WA |
| Mailing Address - Zip Code: | 98115-4118 |
| Mailing Address - Country: | US |
| Mailing Address - Phone: | |
| Mailing Address - Fax: | |
| Practice Address - Street 1: | 101 E 8TH ST STE 110 |
| Practice Address - Street 2: | |
| Practice Address - City: | VANCOUVER |
| Practice Address - State: | WA |
| Practice Address - Zip Code: | 98660-3294 |
| Practice Address - Country: | US |
| Practice Address - Phone: | 206-228-6961 |
| Practice Address - Fax: | |
| EIN: | <UNAVAIL> |
| Is Organization Subpart?: | No |
| Parent Organization LBN: | |
| Parent Organization TIN: | |
| Enumeration Date: | 2025-05-13 |
| Last Update Date: | 2025-10-29 |
| Deactivation Date: | |
| Deactivation Code: | |
| Reactivation Date: |
Provider Taxonomies
| Primary? | Code | Type | Classification | Specialization | Group |
|---|---|---|---|---|---|
| Yes | 133V00000X | Dietary & Nutritional Service Providers | Dietitian, Registered | Group - Multi-Specialty | |
| No | 133N00000X | Dietary & Nutritional Service Providers | Nutritionist | Group - Multi-Specialty |