Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Clark Hazel

Individual provider Clinical Social Worker · NPI 1184238024

Clark Hazel is a Clinical Social Worker in Portland, Oregon. Qualified in 2020, 6 years ago. Practices with Legacy Good Samaritan Hospital and Medical Center, a 192-clinician group, works from 2 locations, accepts Medicare assignment and offers telehealth. Licensed in Oregon.

Years since qualifying
6
Licensed in
OR
In the registry since
2020
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Practice location Address checks out

14600 NW Cornell Rd
Portland, OR 97229-5442
Phone: (503) 645-3581
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 2222 Nw Lovejoy St Ste 606, Portland, OR 97210 — (503) 413-5915

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence L14056 (OR)

Record details

NPI number1184238024
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedSeptember 8, 2020
Last updated in NPPESDecember 17, 2024
Certification dateDecember 17, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2020 (6 years in practice)
Group practice Legacy Good Samaritan Hospital And Medical Center — 192 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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