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General NPI Number Information
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NPI Number | 1245415173
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Entity Type | Individual
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Provider Name | ELLEN MARIE HAMM OTR/L
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Gender | Female
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Dates
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Enumeration Date | 01/09/2008
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Last Update Date | 02/13/2019
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Provider Practice Location Address
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Address Line | 9040 JACKSON AVENUE
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City | TACOMA
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State | WA
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Zip | 98431-2640
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Country | US
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Telephone | 253-968-7924
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Fax |
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Provider Business Mailing Address
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Address Line | 3602 N WARNER ST
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City | TACOMA
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State | WA
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Zip | 98407-6145
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Country | US
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Telephone | 716-812-5229
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225X00000X
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Taxonomy Name | Occupational Therapist
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License Number | 116998
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 005526
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License Number State | NY
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