Provider Demographics
NPI:1245416221
Name:C. STEVENS HAMMER, M.D. INC PS
Entity Type:Organization
Organization Name:C. STEVENS HAMMER, M.D. INC PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:KATHY
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:OSTRANDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-759-3065
Mailing Address - Street 1:4116 N 39TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98407-5717
Mailing Address - Country:US
Mailing Address - Phone:253-752-0801
Mailing Address - Fax:253-759-3075
Practice Address - Street 1:4116 N 39TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98407-5717
Practice Address - Country:US
Practice Address - Phone:253-752-0801
Practice Address - Fax:253-759-3075
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-21
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00010966208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty