Provider Demographics
NPI:1821166893
Name:HINMAN, JERI E (LMP)
Entity Type:Individual
Prefix:
First Name:JERI
Middle Name:E
Last Name:HINMAN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2521 N NETTLETON ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-3861
Mailing Address - Country:US
Mailing Address - Phone:509-680-2929
Mailing Address - Fax:
Practice Address - Street 1:1605 W GARLAND AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-2620
Practice Address - Country:US
Practice Address - Phone:509-444-8383
Practice Address - Fax:509-444-8385
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-30
Last Update Date:2011-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60156040225100000X
WAMA00015317225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0187957OtherLABOR AND INDUSTRIES
WA3593HIOtherASURIS-REGENCE