Provider Demographics
NPI:1841287646
Name:HATTON, SANDRA ROSALIND (LMP, CNT)
Entity type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:ROSALIND
Last Name:HATTON
Suffix:
Gender:F
Credentials:LMP, CNT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1733 N 128TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-7726
Mailing Address - Country:US
Mailing Address - Phone:206-367-5720
Mailing Address - Fax:206-367-9012
Practice Address - Street 1:1733 N 128TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-7726
Practice Address - Country:US
Practice Address - Phone:206-367-5720
Practice Address - Fax:206-367-9012
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00006697225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist