Provider Demographics
NPI:1588901672
Name:HAMPTON, HARRY ALAN (LMP)
Entity type:Individual
Prefix:
First Name:HARRY
Middle Name:ALAN
Last Name:HAMPTON
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:410 BELLEVUE WAY SE
Mailing Address - Street 2:SUITE 202
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98004-6672
Mailing Address - Country:US
Mailing Address - Phone:425-378-1800
Mailing Address - Fax:
Practice Address - Street 1:410 BELLEVUE WAY SE
Practice Address - Street 2:SUITE 202
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6672
Practice Address - Country:US
Practice Address - Phone:425-378-1800
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60279980225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist