Provider Demographics
NPI:1912322652
Name:CONTINUUM THERAPEUTICS, LLC
Entity Type:Organization
Organization Name:CONTINUUM THERAPEUTICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:WADE
Authorized Official - Middle Name:LEE
Authorized Official - Last Name:HAMIL
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:405-627-0276
Mailing Address - Street 1:3816 SHADOWRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-5308
Mailing Address - Country:US
Mailing Address - Phone:405-627-0276
Mailing Address - Fax:405-573-0404
Practice Address - Street 1:4240 MEMORY LN W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-1125
Practice Address - Country:US
Practice Address - Phone:360-286-8513
Practice Address - Fax:888-959-9016
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty