Provider Demographics
NPI:1700425733
Name:HAMM, MA JESSETTHE LIM (RN)
Entity Type:Individual
Prefix:MRS
First Name:MA JESSETTHE
Middle Name:LIM
Last Name:HAMM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:MA JESSETTHE CHRISIN
Other - Middle Name:LIM
Other - Last Name:HAMM
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:6441 S ALDER ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98409-5201
Mailing Address - Country:US
Mailing Address - Phone:252-273-0678
Mailing Address - Fax:
Practice Address - Street 1:6441 S ALDER ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98409-5201
Practice Address - Country:US
Practice Address - Phone:252-273-0678
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-20
Last Update Date:2019-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61020567163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse