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Individual

ANDREW MARK THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
521 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4238
(253) 403-2900
Mailing address
521 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4238
(253) 403-2900

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00033627
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0189776
L & I PROVIDER NUMBER
WA
01
5588475
AETNA PROVIDER NUMBER
WA
05
8195257
WA
01
91120349462
KPS PROVIDER NUMBER
WA
01
98375A009
TRICARE PROVIDER NUMBER
WA
01
TH6800
REGENCE RIDER NUMBER
WA
Enumeration date
06/06/2006
Last updated
08/16/2011
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