Provider Demographics
NPI:1639327232
Name:HAMBLET, SAMANTHA L (OD)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:L
Last Name:HAMBLET
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:SAMANTHA
Other - Middle Name:D
Other - Last Name:LOCY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3409 CAPITOL BLVD SW
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98501-3307
Mailing Address - Country:US
Mailing Address - Phone:360-228-2733
Mailing Address - Fax:
Practice Address - Street 1:3409 CAPITOL BLVD SW
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-3307
Practice Address - Country:US
Practice Address - Phone:360-228-2733
Practice Address - Fax:360-252-8173
Is Sole Proprietor?:No
Enumeration Date:2008-09-08
Last Update Date:2020-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL046010128152W00000X
WAOD60163091152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist