Provider Demographics
NPI:1790037703
Name:HARTJEN, WENDY J
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:J
Last Name:HARTJEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44 GRACE AVE
Mailing Address - Street 2:
Mailing Address - City:WEST YARMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02673-8523
Mailing Address - Country:US
Mailing Address - Phone:508-685-0735
Mailing Address - Fax:508-771-0258
Practice Address - Street 1:44 GRACE AVENUE
Practice Address - Street 2:
Practice Address - City:WEST YARMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02673
Practice Address - Country:US
Practice Address - Phone:508-685-0735
Practice Address - Fax:508-771-0258
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-15
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other