Provider Demographics
NPI:1841307998
Name:HASENMYER, AMBER R (DPT)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:R
Last Name:HASENMYER
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1215 4TH AVE
Practice Address - Street 2:SUITE 1000
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98161-4200
Practice Address - Country:US
Practice Address - Phone:206-622-9001
Practice Address - Fax:425-562-0054
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2024-05-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1135309225100000X
WA60328988225100000X
CA39361225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist