Provider Demographics
NPI:1225566383
Name:HAMASHIN, RUDI LAUREN
Entity Type:Individual
Prefix:
First Name:RUDI
Middle Name:LAUREN
Last Name:HAMASHIN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:RUDI
Other - Middle Name:LAUREN
Other - Last Name:RODRIGUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2905 W BRYANT PL
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-2961
Mailing Address - Country:US
Mailing Address - Phone:813-220-3504
Mailing Address - Fax:
Practice Address - Street 1:1708 BOISE AVE
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:CO
Practice Address - Zip Code:80538
Practice Address - Country:US
Practice Address - Phone:907-663-0815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-01
Last Update Date:2018-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPT30316225100000X
COPTL0015212225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist