Provider Demographics
NPI:1104474295
Name:HANKINS, COLTON CHARLES (LMT)
Entity type:Individual
Prefix:MR
First Name:COLTON
Middle Name:CHARLES
Last Name:HANKINS
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 160
Mailing Address - Street 2:
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019-0160
Mailing Address - Country:US
Mailing Address - Phone:509-860-0948
Mailing Address - Fax:
Practice Address - Street 1:26525 NE ALLEN CT APT 1
Practice Address - Street 2:
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019-5026
Practice Address - Country:US
Practice Address - Phone:509-860-0948
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-31
Last Update Date:2019-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60629361225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist