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NPI Code Detail

MEDICARE: TINA HARDAWAY

MEDICARE: TINA HARDAWAY
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1372600000XAdult Companion

General Provider Information

NPI Number : 1932504396
Entity Type Code : Individual
Provider Name (Legal Business Name) : TINA HARDAWAY
Provider Business Mailing Address
First Line : PO BOX 8459
Second Line :
City : PORTLAND
State : OR
Zip : 97207-8459
Country : US
Telephone Number : 503-238-0769
Fax Number :
Provider Business Practice Location Address
First Line : 7405 SE 84TH AVE
Second Line :
City : PORTLAND
State : OR
Zip : 97266-5840
Country : US
Telephone Number : 503-238-0769
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2014
Last Update Date : 10/28/2014

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Directions to “ TINA HARDAWAY ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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