Provider Demographics
NPI:1962738757
Name:HUNTER, JAMES BRYAN (LMP)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:BRYAN
Last Name:HUNTER
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 1:222 NE 4TH AVE
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-2124
Mailing Address - Country:US
Mailing Address - Phone:641-233-0985
Mailing Address - Fax:
Practice Address - Street 1:17510 NE 3RD ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-3731
Practice Address - Country:US
Practice Address - Phone:641-233-0985
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60103752172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist