Provider Demographics
NPI:1699451765
Name:HARTIGAN, JON DAVID (CPC)
Entity type:Individual
Prefix:
First Name:JON
Middle Name:DAVID
Last Name:HARTIGAN
Suffix:
Gender:M
Credentials:CPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:715 WILSON ST NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-4712
Mailing Address - Country:US
Mailing Address - Phone:412-712-5268
Mailing Address - Fax:
Practice Address - Street 1:1011 10TH AVE SE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1566
Practice Address - Country:US
Practice Address - Phone:412-712-5268
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-23
Last Update Date:2023-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist