Provider Demographics
NPI:1093841769
Name:HAMMERS, CRYSTAL K (LMP, LMT)
Entity Type:Individual
Prefix:MRS
First Name:CRYSTAL
Middle Name:K
Last Name:HAMMERS
Suffix:
Gender:F
Credentials:LMP, LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1060 HUDSON ST
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-3103
Mailing Address - Country:US
Mailing Address - Phone:360-423-2037
Mailing Address - Fax:360-423-9320
Practice Address - Street 1:1060 HUDSON ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-3103
Practice Address - Country:US
Practice Address - Phone:360-423-2037
Practice Address - Fax:360-423-9320
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2015-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00023562225700000X
OR21381225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist