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Individual
THOMAS N SHELTON
Active
Individual
THOMAS N SHELTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP00001078
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0255578
STATE L&I
WA
01
—
0263630
STATE L&I
WA
01
—
0263632
STATE L&I
WA
01
—
0263633
STATE L&I
WA
01
—
0263636
STATE L&I
WA
01
—
0263638
STATE L&I
WA
01
—
0263641
STATE L&I
WA
01
—
0263642
STATE L&I
WA
01
—
0263650
STATE L&I
WA
01
—
0263655
STATE L&I
WA
01
—
0263658
STATE L&I
WA
01
—
0267959
STATE L&I
WA
01
—
0268165
STATE L&I
WA
01
—
5840SH
REGENCE BLUE SHIELD RIDER
WA
01
—
911465840
FEDERAL TAX ID
WA
Enumeration date
06/15/2005
Last updated
04/06/2011
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