Basic Information
| Provider Information | |||||||||
| NPI: | 1235218363 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAMMER | ||||||||
| FirstName: | CARL | ||||||||
| MiddleName: | STEVENS | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 101 E. 26TH STREET | ||||||||
| Address2: | SUITE 205 | ||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984211108 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2535974550 | ||||||||
| FaxNumber: | 2533832596 | ||||||||
| Practice Location | |||||||||
| Address1: | 1708 EAST 44TH STREET | ||||||||
| Address2: | EASTSIDE TANBARA MEDICAL | ||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 98404 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2534714553 | ||||||||
| FaxNumber: | 2534745396 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/02/2006 | ||||||||
| LastUpdateDate: | 08/20/2010 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | MD00010966 | WA | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 1983778 | 05 | WA | MEDICAID |