Hardie, Willie M

Hardie, Willie M is an sole proprietor health care provider with primary practice located at 925 Ne 136Th Ave Suite 101, Vancouver WA 98684-0896. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Hardie, Willie M can be contacted via phone (360) 694-5559.

Contact Information

Primary practice address
925 Ne 136Th Ave Suite 101 Vancouver WA 98684-0896
Phone: (360) 694-5559
Fax: (360) 891-0000
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X DE00008741 Washington

Profile Details

NPI number 1093891533
LBN Legal business name Hardie, Willie M
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 27th, 2006
Last updated Sep 14th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1093891533 NPPES
Washington Other 2007980 GROUP MEDICAID
Washington MEDICAID 1002369 GROUP MEDICAID

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