MEDICARE: MR. STEPHEN R HAMMIL M.A.

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
1	170300000X	Genetic Counselor (M.S.)	RC60001471	WA

General Provider Information

NPI Number	:	1477783512
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STEPHEN R HAMMIL M.A.

Provider Business Mailing Address
First Line	:	6041 36TH AVE NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98115-7401
Country	:	US
Telephone Number	:	206-522-2781
Fax Number	:

Provider Business Practice Location Address
First Line	:	1314 NE 43RD ST STE 213
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98105-5832
Country	:	US
Telephone Number	:	206-856-9111
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/23/2009
Last Update Date	:	07/23/2009

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