Provider Demographics
NPI:1679396212
Name:GREENE, HAZEL RUTH
Entity type:Individual
Prefix:
First Name:HAZEL
Middle Name:RUTH
Last Name:GREENE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:HAZEL
Other - Middle Name:RUTH
Other - Last Name:GREENE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 433
Mailing Address - Street 2:
Mailing Address - City:NEAH BAY
Mailing Address - State:WA
Mailing Address - Zip Code:98357-0433
Mailing Address - Country:US
Mailing Address - Phone:360-640-8487
Mailing Address - Fax:
Practice Address - Street 1:PO BOX 433
Practice Address - Street 2:
Practice Address - City:NEAH BAY
Practice Address - State:WA
Practice Address - Zip Code:98357-0433
Practice Address - Country:US
Practice Address - Phone:360-640-8487
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-11-04
Last Update Date:2024-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula