Provider Demographics
NPI:1043058050
Name:HAMMOND, TESSA LYNN (RN)
Entity type:Individual
Prefix:
First Name:TESSA
Middle Name:LYNN
Last Name:HAMMOND
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4402 155TH ST
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:WA
Mailing Address - Zip Code:98631-6309
Mailing Address - Country:US
Mailing Address - Phone:320-360-2466
Mailing Address - Fax:
Practice Address - Street 1:201 7TH ST
Practice Address - Street 2:
Practice Address - City:HOQUIAM
Practice Address - State:WA
Practice Address - Zip Code:98550-2506
Practice Address - Country:US
Practice Address - Phone:360-532-5454
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-16
Last Update Date:2024-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61033910163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management