1548642960 NPI number — DARLENE GERTRUDE HAMPTON

Table of content: DARLENE GERTRUDE HAMPTON (NPI 1548642960)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1548642960 NPI number — DARLENE GERTRUDE HAMPTON

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAMPTON
Provider First Name:
DARLENE
Provider Middle Name:
GERTRUDE
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
WATKINS-HAMPTON
Provider Other First Name:
DARLENE
Provider Other Middle Name:
GERTRUDE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1548642960
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/22/2015
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
P.O BOX 3810
Provider Second Line Business Mailing Address:
COMPASS HEALTH
Provider Business Mailing Address City Name:
EVERETT
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98213
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-349-8359
Provider Business Mailing Address Fax Number:
425-349-8348

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3322 BROADWAY
Provider Second Line Business Practice Location Address:
COMPASS HEALTH
Provider Business Practice Location Address City Name:
EVERETT
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98201
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-349-6800
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/22/2015

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)