Provider Demographics
NPI:1154404572
Name:HAMMER, JOHN HERBERT (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:HERBERT
Last Name:HAMMER
Suffix:
Gender:M
Credentials:DC
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 551
Mailing Address - Street 2:
Mailing Address - City:OMAK
Mailing Address - State:WA
Mailing Address - Zip Code:98841-0551
Mailing Address - Country:US
Mailing Address - Phone:509-826-2111
Mailing Address - Fax:509-826-1334
Practice Address - Street 1:208 W FOURTH
Practice Address - Street 2:
Practice Address - City:OMAK
Practice Address - State:WA
Practice Address - Zip Code:98841-0551
Practice Address - Country:US
Practice Address - Phone:509-826-2111
Practice Address - Fax:509-826-1334
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-21
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3140111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2020949Medicaid
911833133OtherHMO
HA1266OtherASURIS NW HEALTH
WA114053OtherLABOR & INDUSTRIES
911833133OtherCOMMERCIAL
P00153320OtherRAILROAD MEDICARE
911833133OtherPPO
911833133OtherBLUE CROSS BLUE SHIELD
911833133OtherPPO
WAGAB00853Medicare PIN
WA114053OtherLABOR & INDUSTRIES