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NPI Code Detail

MEDICARE: MS. ELLEN MARIE HAMM OTR/L

MEDICARE: MS. ELLEN MARIE HAMM OTR/L
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
1225X00000XOccupational Therapist116998TX
2174400000XSpecialist005526NY

General Provider Information

NPI Number : 1245415173
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. ELLEN MARIE HAMM OTR/L
Provider Business Mailing Address
First Line : 3602 N WARNER ST
Second Line :
City : TACOMA
State : WA
Zip : 98407-6145
Country : US
Telephone Number : 716-812-5229
Fax Number :
Provider Business Practice Location Address
First Line : 9040 JACKSON AVENUE
Second Line :
City : TACOMA
State : WA
Zip : 98431-2640
Country : US
Telephone Number : 253-968-7924
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2008
Last Update Date : 02/13/2019

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