Provider Demographics
NPI:1992843627
Name:HAMLIN, MINDY ANNE (LMP)
Entity Type:Individual
Prefix:
First Name:MINDY
Middle Name:ANNE
Last Name:HAMLIN
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 1:624 N FOREST ST
Mailing Address - Street 2:APT A
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5314
Mailing Address - Country:US
Mailing Address - Phone:360-820-9306
Mailing Address - Fax:
Practice Address - Street 1:624 N FOREST ST
Practice Address - Street 2:APT A
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5314
Practice Address - Country:US
Practice Address - Phone:360-820-9306
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022468225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist