Provider Demographics
NPI:1831341916
Name:HAMMAN, JAMES (BCBA, LBA)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:
Last Name:HAMMAN
Suffix:
Gender:M
Credentials:BCBA, LBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1325
Mailing Address - Street 2:
Mailing Address - City:CHILOQUIN
Mailing Address - State:OR
Mailing Address - Zip Code:97624-1325
Mailing Address - Country:US
Mailing Address - Phone:541-591-5669
Mailing Address - Fax:541-600-4638
Practice Address - Street 1:140 S 1ST AVE
Practice Address - Street 2:
Practice Address - City:CHILOQUIN
Practice Address - State:OR
Practice Address - Zip Code:97624-9738
Practice Address - Country:US
Practice Address - Phone:541-591-5669
Practice Address - Fax:541-600-4638
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-21
Last Update Date:2020-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1-02-0785103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500762298Medicaid