Provider Demographics
NPI:1093844755
Name:HOOD, TAMMERA MICHELLE (LMP)
Entity Type:Individual
Prefix:MRS
First Name:TAMMERA
Middle Name:MICHELLE
Last Name:HOOD
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3627 WHEATON WAY STE 105A
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-3510
Mailing Address - Country:US
Mailing Address - Phone:360-377-3601
Mailing Address - Fax:360-373-9494
Practice Address - Street 1:3627 WHEATON WAY STE 105A
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-3510
Practice Address - Country:US
Practice Address - Phone:360-377-3601
Practice Address - Fax:360-373-9494
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00012111225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0123288OtherL&I
WA912115091-02OtherKPS