Provider Demographics
NPI:1831140185
Name:HADLEY, KARL DAVID (MD)
Entity Type:Individual
Prefix:
First Name:KARL
Middle Name:DAVID
Last Name:HADLEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9621 RIDGETOP BLVD NW
Mailing Address - Street 2:
Mailing Address - City:SILVERDALE
Mailing Address - State:WA
Mailing Address - Zip Code:98383-8502
Mailing Address - Country:US
Mailing Address - Phone:360-782-3501
Mailing Address - Fax:
Practice Address - Street 1:19245 7TH AVE NE
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-7504
Practice Address - Country:US
Practice Address - Phone:360-782-3500
Practice Address - Fax:360-782-3540
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00018482207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA75431OtherLABOR & INDUSTRIES
5992027OtherAETNA
WA8931483OtherCRIME VICTIMS COMP
080036378OtherRAILROAD MEDICARE
WA1765304Medicaid
HA9123OtherREGENCE BLUE SHIELD
HA9123OtherREGENCE BLUE SHIELD
G8879101Medicare PIN
WAG000250412Medicare PIN
WA8931483OtherCRIME VICTIMS COMP
5992027OtherAETNA
080036378OtherRAILROAD MEDICARE
AH8967385OtherDEA
WA75431OtherLABOR & INDUSTRIES
A06928Medicare UPIN
G8896306Medicare PIN