Healthcare Provider Details

I. General information

NPI: 1912322652
Provider Name (Legal Business Name): CONTINUUM THERAPEUTICS, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/04/2014
Last Update Date: 03/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4240 MEMORY LN W
UNIVERSITY PLACE WA
98466-1125
US

IV. Provider business mailing address

3816 SHADOWRIDGE DR
NORMAN OK
73072-5308
US

V. Phone/Fax

Practice location:
  • Phone: 360-286-8513
  • Fax: 888-959-9016
Mailing address:
  • Phone: 405-627-0276
  • Fax: 405-573-0404

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number StateWA

VIII. Authorized Official

Name: DR. WADE LEE HAMIL
Title or Position: MANAGING MEMBER
Credential: PHD
Phone: 405-627-0276