Provider Demographics
NPI:1003389040
Name:HAMILTON, TAMMIE (LMT)
Entity Type:Individual
Prefix:
First Name:TAMMIE
Middle Name:
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2256 MOTTMAN RD SW STE C
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-4200
Mailing Address - Country:US
Mailing Address - Phone:360-357-5222
Mailing Address - Fax:
Practice Address - Street 1:2256 MOTTMAN RD SW STE C
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-4200
Practice Address - Country:US
Practice Address - Phone:360-357-5222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-01-02
Last Update Date:2019-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60667251225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist