Provider Demographics
NPI:1376841411
Name:HOPPER, PATRICIA J (LMP)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:J
Last Name:HOPPER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:PATRICIA
Other - Middle Name:J
Other - Last Name:HAMILTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8809 23RD AVE NE APT 2
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-3395
Mailing Address - Country:US
Mailing Address - Phone:206-450-9060
Mailing Address - Fax:
Practice Address - Street 1:549 MAIN ST
Practice Address - Street 2:
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-3149
Practice Address - Country:US
Practice Address - Phone:206-850-8281
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-13
Last Update Date:2011-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60199223225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist