Provider Demographics
NPI:1942503776
Name:HAMILTON, BERET ANN (LMP)
Entity Type:Individual
Prefix:MISS
First Name:BERET
Middle Name:ANN
Last Name:HAMILTON
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 1:400 N 34TH ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-8600
Mailing Address - Country:US
Mailing Address - Phone:206-941-3026
Mailing Address - Fax:206-632-4576
Practice Address - Street 1:400 N 34TH ST STE 300
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-8600
Practice Address - Country:US
Practice Address - Phone:206-941-3026
Practice Address - Fax:206-632-4576
Is Sole Proprietor?:Yes
Enumeration Date:2010-12-16
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60188172225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist