Provider Demographics
NPI:1083853931
Name:GLAZIER, PATRICIA HAZEL (NP)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:HAZEL
Last Name:GLAZIER
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1719
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-1719
Mailing Address - Country:US
Mailing Address - Phone:503-352-3854
Mailing Address - Fax:503-924-2769
Practice Address - Street 1:4660 NE BELKNAP CT
Practice Address - Street 2:SUITE 109
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-6467
Practice Address - Country:US
Practice Address - Phone:503-693-1944
Practice Address - Fax:503-693-1941
Is Sole Proprietor?:No
Enumeration Date:2009-02-17
Last Update Date:2009-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR077038633N1 FNP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily