| Doctor Name: | JOHN HAMMACK |
| NPI Number: | 1073852356 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MA |
| License Number: | LH60536005 |
| Business Practice Address: | 7304 10th St Se B201 Lake Stevens, WA - 982583684 |
| Business Phone Number: | 4258705142 |
| Business Fax Number: | |
| Mailing Address: | 7304 10th St Se, B201 LAKE STEVENS |
| State: | WA |
| Postal Code: | 982583684 |
| Phone Number: | 4258705142 |
| Fax Number: | |
| NPI Enumeration Date: | 02/06/2013 |
| NPI Last Update Date: | 02/22/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YM0800X |
| License Number: | LH60536005 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Mental Health |
| Taxonomy Definition: | |