Provider Demographics
NPI:1477186575
Name:HARDY, ASPEN (SUDP)
Entity Type:Individual
Prefix:MS
First Name:ASPEN
Middle Name:
Last Name:HARDY
Suffix:
Gender:F
Credentials:SUDP
Other - Prefix:MS
Other - First Name:ASPEN
Other - Middle Name:
Other - Last Name:PERKINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:SUDPT
Mailing Address - Street 1:1210 SW 136TH ST
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-1214
Mailing Address - Country:US
Mailing Address - Phone:206-495-1750
Mailing Address - Fax:206-257-6851
Practice Address - Street 1:1210 SW 136TH ST
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-1214
Practice Address - Country:US
Practice Address - Phone:206-495-1750
Practice Address - Fax:206-257-6851
Is Sole Proprietor?:No
Enumeration Date:2020-02-17
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACP60880476101YA0400X, 101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)