Provider Demographics
NPI:1639966617
Name:HATCH-RIZZI, THERESA MARY
Entity type:Individual
Prefix:MS
First Name:THERESA
Middle Name:MARY
Last Name:HATCH-RIZZI
Suffix:
Gender:
Credentials:
Other - Prefix:MS
Other - First Name:TRACEY
Other - Middle Name:
Other - Last Name:HATCH-RIZZI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LAC
Mailing Address - Street 1:1431 SE DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97202-1139
Mailing Address - Country:US
Mailing Address - Phone:503-234-2212
Mailing Address - Fax:
Practice Address - Street 1:1431 SE DIVISION ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1139
Practice Address - Country:US
Practice Address - Phone:503-234-2212
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-22
Last Update Date:2025-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00765171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist