MEDICARE: CHARLI HAMILTON LMT

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	225700000X	Massage Therapist	MASS.MA.60787215	WA

General Provider Information

NPI Number	:	1801351572
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHARLI HAMILTON LMT

Provider Business Mailing Address
First Line	:	5536 KINA PL SE
Second Line	:
City	:	PORT ORCHARD
State	:	WA
Zip	:	98367-4548
Country	:	US
Telephone Number	:	206-800-1030
Fax Number	:

Provider Business Practice Location Address
First Line	:	1751 NW 57TH ST
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98107-3034
Country	:	US
Telephone Number	:	206-800-1030
Fax Number	:

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

Provider Enumeration Date	:	02/06/2019
Last Update Date	:	01/28/2025

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Directions to “ CHARLI HAMILTON LMT” Practice Location

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