Provider Demographics
NPI:1790233880
Name:MORALEJA, HAZEL B (MSW)
Entity Type:Individual
Prefix:
First Name:HAZEL
Middle Name:B
Last Name:MORALEJA
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18607 BLUE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-4129
Mailing Address - Country:US
Mailing Address - Phone:206-250-9637
Mailing Address - Fax:
Practice Address - Street 1:1016 E PIKE ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-3847
Practice Address - Country:US
Practice Address - Phone:206-957-1606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-17
Last Update Date:2016-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60624732101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health