Provider Demographics
NPI:1881679017
Name:HARDIE, MONICA J (MD)
Entity Type:Individual
Prefix:DR
First Name:MONICA
Middle Name:J
Last Name:HARDIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:104 W 5TH AVE
Mailing Address - Street 2:SUITE 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:SUITE 200W
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-4880
Practice Address - Country:US
Practice Address - Phone:509-744-3750
Practice Address - Fax:509-744-3969
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00034431207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G45159Medicare UPIN