Provider Demographics
NPI:1558758789
Name:HADLOCK, JENNIFER JANE (MD)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:JANE
Last Name:HADLOCK
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:HADLOCK
Other - Last Name:BEERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:104 W 5TH AVE
Mailing Address - Street 2:STE 200W
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-4880
Mailing Address - Country:US
Mailing Address - Phone:509-744-3750
Mailing Address - Fax:509-744-3969
Practice Address - Street 1:104 W 5TH AVE
Practice Address - Street 2:STE 200W
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-4880
Practice Address - Country:US
Practice Address - Phone:509-624-2313
Practice Address - Fax:509-459-0686
Is Sole Proprietor?:No
Enumeration Date:2015-04-26
Last Update Date:2015-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program