Provider Demographics
NPI:1174134746
Name:HAZEL, CARMEN SOFIA (MEDICAL INTERPRETER)
Entity type:Individual
Prefix:
First Name:CARMEN
Middle Name:SOFIA
Last Name:HAZEL
Suffix:
Gender:F
Credentials:MEDICAL INTERPRETER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3900 W 19TH CT
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-1941
Mailing Address - Country:US
Mailing Address - Phone:509-628-6887
Mailing Address - Fax:
Practice Address - Street 1:3900 W 19TH CT
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99338-1941
Practice Address - Country:US
Practice Address - Phone:509-628-6887
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-16
Last Update Date:2020-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA603425722171R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171R00000XOther Service ProvidersInterpreter