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NPI Code Detail

MEDICARE: WESTON M VANDENHAZEL

MEDICARE: WESTON M VANDENHAZEL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1101Y00000XCounselorCG61668515WA

General Provider Information

NPI Number : 1437957719
Entity Type Code : Individual
Provider Name (Legal Business Name) : WESTON M VANDENHAZEL
Provider Business Mailing Address
First Line : PO BOX 2394
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-8455
Country : US
Telephone Number : 360-200-5419
Fax Number : 844-612-6673
Provider Business Practice Location Address
First Line : 1340 12TH AVE STE 100
Second Line :
City : LONGVIEW
State : WA
Zip : 98632-3820
Country : US
Telephone Number : 360-200-5419
Fax Number : 844-612-6673
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/04/2025
Last Update Date : 03/04/2025

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Directions to “ WESTON M VANDENHAZEL ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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