Provider Demographics
NPI:1902851959
Name:HAMM, LEONARD (MD)
Entity Type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:
Last Name:HAMM
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 HARBOR SEAL DR
Mailing Address - Street 2:
Mailing Address - City:POINT ROBERTS
Mailing Address - State:WA
Mailing Address - Zip Code:98281-8611
Mailing Address - Country:US
Mailing Address - Phone:571-218-9332
Mailing Address - Fax:
Practice Address - Street 1:342 FAIRVIEW ST
Practice Address - Street 2:
Practice Address - City:SILVERTON
Practice Address - State:OR
Practice Address - Zip Code:97381-1917
Practice Address - Country:US
Practice Address - Phone:503-873-1500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2010-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00043767207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
D18301Medicare UPIN