Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225700000X | Massage Therapist | MA00021821 | WA |
NPI | 1013248327 |
---|---|
Provider Name | Michael Hamm |
First Address | Seattle, WA 98112-4047 |
Second Address | Seattle, WA 98103-6900 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2010 |
Last Update Date | 23/08/2019 |