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General NPI Number Information
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NPI Number | 1538291315
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Entity Type | Individual
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Provider Name | SHADEE ALEA HARDY LICSW
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Gender | Female
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Dates
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Enumeration Date | 03/09/2007
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Last Update Date | 02/25/2026
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Provider Practice Location Address
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Address Line | 905 SE 14TH AVE
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City | PORTLAND
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State | OR
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Zip | 97214-2569
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Country | US
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Telephone | 503-622-8964
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Fax |
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Provider Business Mailing Address
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Address Line | 1624 HARMON PL SUITE 300J
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City | MINNEAPOLIS
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State | MN
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Zip | 55403-1916
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Country | US
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Telephone | 612-345-8115
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Fax | 612-486-5537
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | L5853
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License Number State | OR
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