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NPI Code Detail

MEDICARE: LORENNA MAYLEE HAMMONS

MEDICARE: LORENNA MAYLEE HAMMONS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106S00000XBehavior TechnicianBACB468060WA
2103K00000XBehavior AnalystCB61219826WA

General Provider Information

NPI Number : 1366141236
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORENNA MAYLEE HAMMONS
Provider Business Mailing Address
First Line : PO BOX 124
Second Line :
City : TOLEDO
State : WA
Zip : 98591-0124
Country : US
Telephone Number : 310-465-9722
Fax Number :
Provider Business Practice Location Address
First Line : 1217 COOPER POINT RD SW STE 5
Second Line :
City : OLYMPIA
State : WA
Zip : 98502-7206
Country : US
Telephone Number : 360-464-9052
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/28/2023
Last Update Date : 06/10/2024

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Directions to “ LORENNA MAYLEE HAMMONS ” Practice Location

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