Individual
JACK HAMSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
826 ALDER ST, SOUTH BEND, WA 98586-4900
(360) 875-5579
Mailing address
PO BOX 143, RAYMOND, WA 98577-0143
(510) 219-2184
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD200995
OR
Other
Enumeration date
04/12/2017
Last updated
02/12/2022
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