Provider Demographics
NPI:1912085838
Name:HAMILL, DARRELL MARIE (MS, PT, HPCS)
Entity Type:Individual
Prefix:
First Name:DARRELL
Middle Name:MARIE
Last Name:HAMILL
Suffix:
Gender:F
Credentials:MS, PT, HPCS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33330 8TH AVE S
Mailing Address - Street 2:
Mailing Address - City:FEDERAL WAY
Mailing Address - State:WA
Mailing Address - Zip Code:98003-6325
Mailing Address - Country:US
Mailing Address - Phone:253-945-2086
Mailing Address - Fax:253-945-2177
Practice Address - Street 1:35101 5TH AVE SW
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98023-8108
Practice Address - Country:US
Practice Address - Phone:253-945-2619
Practice Address - Fax:253-945-2177
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2012-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT00002086225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7123805Medicaid