Provider Demographics
NPI:1487093530
Name:HARTMAN, JANELL ALICIA
Entity type:Individual
Prefix:MS
First Name:JANELL
Middle Name:ALICIA
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4470 SUNDAY DR
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-9600
Mailing Address - Country:US
Mailing Address - Phone:206-979-5325
Mailing Address - Fax:
Practice Address - Street 1:4470 SUNDAY DR
Practice Address - Street 2:
Practice Address - City:OAK HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98277-9600
Practice Address - Country:US
Practice Address - Phone:206-979-5325
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-21
Last Update Date:2013-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor