Provider Demographics
NPI:1629167945
Name:HAMILTON, CHARLES A (DC)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:A
Last Name:HAMILTON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 NORTH 67TH
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-5209
Mailing Address - Country:US
Mailing Address - Phone:206-784-4672
Mailing Address - Fax:
Practice Address - Street 1:301 NORTH 67TH
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-5209
Practice Address - Country:US
Practice Address - Phone:206-784-4672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2386111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
39967OtherL & I
39967OtherL & I
T92538Medicare UPIN