Provider Demographics
NPI:1841612207
Name:HAMMER, SAMUEL EDWARD (LMP)
Entity Type:Individual
Prefix:MR
First Name:SAMUEL
Middle Name:EDWARD
Last Name:HAMMER
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3018 NW 85TH ST # 11B
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98117-3902
Mailing Address - Country:US
Mailing Address - Phone:860-944-5064
Mailing Address - Fax:
Practice Address - Street 1:9415 ROOSEVELT WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2843
Practice Address - Country:US
Practice Address - Phone:860-944-5064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-19
Last Update Date:2014-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60433575225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist