Provider Demographics
NPI:1972569044
Name:HAMMOND, KIMBERLEE RENEE (PT)
Entity Type:Individual
Prefix:MRS
First Name:KIMBERLEE
Middle Name:RENEE
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1225 N ARGONNE RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-2798
Mailing Address - Country:US
Mailing Address - Phone:509-505-5315
Mailing Address - Fax:509-530-2837
Practice Address - Street 1:1225 N ARGONNE RD STE 100
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-2798
Practice Address - Country:US
Practice Address - Phone:509-505-5315
Practice Address - Fax:509-530-2837
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2023-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT000064352251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA20-060080OtherTAX IDENIFICATON
WA0146235OtherL&I PROVIDER
WA8318479Medicaid
WA0146235OtherL&I PROVIDER