Provider Demographics
NPI:1255064473
Name:HARTMAN, JODIE DAWN (MSW)
Entity type:Individual
Prefix:MISS
First Name:JODIE
Middle Name:DAWN
Last Name:HARTMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:JODIE
Other - Middle Name:DAWN
Other - Last Name:HARTMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MSW
Mailing Address - Street 1:9600 VETERANS DR SW
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98493-0003
Mailing Address - Country:US
Mailing Address - Phone:253-583-3701
Mailing Address - Fax:
Practice Address - Street 1:9600 VETERANS DR SW
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98493-0003
Practice Address - Country:US
Practice Address - Phone:253-583-3701
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-06
Last Update Date:2023-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC160691041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical