Provider Demographics
NPI:1316639362
Name:TINGLE HARDMAN, STEPHANIE (NBHWC)
Entity type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:
Last Name:TINGLE HARDMAN
Suffix:
Gender:F
Credentials:NBHWC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5830 BILLINGS RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT HOOD PARKDALE
Mailing Address - State:OR
Mailing Address - Zip Code:97041-7612
Mailing Address - Country:US
Mailing Address - Phone:541-399-2677
Mailing Address - Fax:
Practice Address - Street 1:5830 BILLINGS RD
Practice Address - Street 2:
Practice Address - City:MOUNT HOOD PARKDALE
Practice Address - State:OR
Practice Address - Zip Code:97041-7612
Practice Address - Country:US
Practice Address - Phone:541-399-2677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-05-25
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA-3783426171400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach