Provider Demographics
NPI:1134566672
Name:HAMAR, SAMANTHA DIANE (LMHCA)
Entity type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:DIANE
Last Name:HAMAR
Suffix:
Gender:F
Credentials:LMHCA
Other - Prefix:
Other - First Name:THEA
Other - Middle Name:DIANE
Other - Last Name:SHIRA
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMHCA
Mailing Address - Street 1:3417 EVANSTON AVE N
Mailing Address - Street 2:SUITE 415
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103
Mailing Address - Country:US
Mailing Address - Phone:206-456-6754
Mailing Address - Fax:
Practice Address - Street 1:3417 EVANSTON AVE N
Practice Address - Street 2:SUITE 415
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103
Practice Address - Country:US
Practice Address - Phone:206-456-6754
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-23
Last Update Date:2018-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60882908101YM0800X
WACG60315060101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health