Provider Demographics
NPI:1760759039
Name:CONDREAY, HANNAH JOY (MA)
Entity Type:Individual
Prefix:MS
First Name:HANNAH
Middle Name:JOY
Last Name:CONDREAY
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 74TH STREET CT E APT D104
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98404-3378
Mailing Address - Country:US
Mailing Address - Phone:253-314-9026
Mailing Address - Fax:
Practice Address - Street 1:1715 74TH STREET CT E APT D104
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98404-3378
Practice Address - Country:US
Practice Address - Phone:253-314-9026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-30
Last Update Date:2011-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60261799225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist