Provider Demographics
NPI:1710245576
Name:HAMMERSMARK, EYVIND
Entity Type:Individual
Prefix:MR
First Name:EYVIND
Middle Name:
Last Name:HAMMERSMARK
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:EYVIND
Other - Middle Name:
Other - Last Name:HAMMERSMARK
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMFT
Mailing Address - Street 1:10309 NE 185TH ST
Mailing Address - Street 2:
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011-3437
Mailing Address - Country:US
Mailing Address - Phone:425-485-6541
Mailing Address - Fax:425-485-4154
Practice Address - Street 1:10309 NE 185TH ST
Practice Address - Street 2:
Practice Address - City:BOTHELL
Practice Address - State:WA
Practice Address - Zip Code:98011-3437
Practice Address - Country:US
Practice Address - Phone:425-485-6541
Practice Address - Fax:425-485-4154
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2012-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00005556101YM0800X
WALF 00001457106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health