Provider Demographics
NPI:1871939074
Name:NANCY L HAMLIN, LLC
Entity type:Organization
Organization Name:NANCY L HAMLIN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ARNP
Authorized Official - Prefix:DR
Authorized Official - First Name:NANCY
Authorized Official - Middle Name:
Authorized Official - Last Name:HAMLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:360-490-4255
Mailing Address - Street 1:2722 COLBY AVE
Mailing Address - Street 2:328
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98201-3557
Mailing Address - Country:US
Mailing Address - Phone:425-740-3600
Mailing Address - Fax:425-740-3601
Practice Address - Street 1:2722 COLBY AVE
Practice Address - Street 2:328
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3557
Practice Address - Country:US
Practice Address - Phone:425-740-3600
Practice Address - Fax:425-740-3601
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-14
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30006558363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9639378Medicaid