Provider Demographics
NPI:1245383801
Name:HUNT, TERRY (LMP)
Entity Type:Individual
Prefix:MR
First Name:TERRY
Middle Name:
Last Name:HUNT
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2366 EASTLAKE AVE E
Mailing Address - Street 2:SUITE 235
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3366
Mailing Address - Country:US
Mailing Address - Phone:206-325-2793
Mailing Address - Fax:206-325-2794
Practice Address - Street 1:2366 EASTLAKE AVE E
Practice Address - Street 2:SUITE 235
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3366
Practice Address - Country:US
Practice Address - Phone:206-325-2793
Practice Address - Fax:206-325-2794
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 10482174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist