Provider Demographics
NPI:1972898138
Name:HAMPTON, JANENE (LMP)
Entity Type:Individual
Prefix:
First Name:JANENE
Middle Name:
Last Name:HAMPTON
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 1:14725 NE 20TH ST
Mailing Address - Street 2:D-73
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3732
Mailing Address - Country:US
Mailing Address - Phone:206-504-6014
Mailing Address - Fax:425-454-1995
Practice Address - Street 1:820 102ND AVE NE # 300
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-4117
Practice Address - Country:US
Practice Address - Phone:206-504-6014
Practice Address - Fax:425-454-1995
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2016-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60231483225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist