Provider Demographics
NPI:1598964470
Name:HARDTKE'S HOUSE CALLS, LLC
Entity Type:Organization
Organization Name:HARDTKE'S HOUSE CALLS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PART OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOANNE
Authorized Official - Middle Name:GIGI
Authorized Official - Last Name:HARDTKE
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:253-212-0093
Mailing Address - Street 1:3702 S FIFE ST STE K
Mailing Address - Street 2:PMB 402
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409
Mailing Address - Country:US
Mailing Address - Phone:253-212-0093
Mailing Address - Fax:866-375-6026
Practice Address - Street 1:1540 VENTURA DR
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98465
Practice Address - Country:US
Practice Address - Phone:253-212-0093
Practice Address - Fax:866-375-6026
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-12
Last Update Date:2007-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006122363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty