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General NPI Number Information
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NPI Number | 1831909522
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Entity Type | Individual
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Provider Name | MARISSA FAITH HAZELET CPM, LM
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Gender | Female
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Dates
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Enumeration Date | 01/13/2025
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Last Update Date | 09/09/2025
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Provider Practice Location Address
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Address Line | 948 STEVENS DR STE C
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City | RICHLAND
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State | WA
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Zip | 99352-3547
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Country | US
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Telephone | 509-905-9000
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Fax | 509-606-0414
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Provider Business Mailing Address
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Address Line | 948 STEVENS DR STE C
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City | RICHLAND
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State | WA
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Zip | 99352-3547
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Country | US
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Telephone | 509-905-9000
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Fax | 509-606-0414
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number |
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License Number State |
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