Healthcare Provider Details

I. General information

NPI: 1659110948
Provider Name (Legal Business Name): HAZZAUNA MARIE UNDERWOOD APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/24/2024
Last Update Date: 03/06/2026
Certification Date: 03/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8124 BEVERLY LN
EVERETT WA
98203-6403
US

IV. Provider business mailing address

8124 BEVERLY LN
EVERETT WA
98203-6403
US

V. Phone/Fax

Practice location:
  • Phone: 425-405-2402
  • Fax:
Mailing address:
  • Phone: 425-405-2402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP70055481
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: