Individual
MS. MARYALICE RENATE HARDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1806 W LINCOLN AVE, YAKIMA, WA 98902-2473
(509) 452-4520
(509) 452-5224
Mailing address
501 S 5TH AVE, YAKIMA, WA 98902-3550
(509) 853-1082
(509) 573-6275
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP60712802
WA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP60712802
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
13943718
—
WA
Enumeration date
10/18/2016
Last updated
10/06/2025
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