Provider Demographics
NPI:1568764462
Name:HAMM, SUSAN PHILLIPS (RPH)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:PHILLIPS
Last Name:HAMM
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8340 15TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-3603
Mailing Address - Country:US
Mailing Address - Phone:206-782-7480
Mailing Address - Fax:206-782-7842
Practice Address - Street 1:8340 15TH AVE NW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98117-3603
Practice Address - Country:US
Practice Address - Phone:206-782-7480
Practice Address - Fax:206-782-7842
Is Sole Proprietor?:No
Enumeration Date:2010-11-27
Last Update Date:2010-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00011177183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist