Healthcare Provider Details

I. General information

NPI: 1588816193
Provider Name (Legal Business Name): AMBER BRIDGET HAMLIN LMP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: AMBER BRIDGET CHORVAT LMP

II. Dates (important events)

Enumeration Date: 10/14/2008
Last Update Date: 08/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 N ARGONNE RD BLDG B SUITE BL-2
SPOKANE VALLEY WA
99212-2869
US

IV. Provider business mailing address

505 N ARGONNE RD BLDG B SUITE BL-2
SPOKANE VALLEY WA
99212-2869
US

V. Phone/Fax

Practice location:
  • Phone: 509-475-9174
  • Fax:
Mailing address:
  • Phone: 509-475-9174
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172M00000X
TaxonomyMechanotherapist
License NumberMA00013238
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: