Individual
THOMAS W PENDERGRASS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., M.S.P.H.
Contact information
Practice address
4800 SAND POINT WAY NE, SEATTLE, WA 98105
(206) 987-2106
(206) 987-5105
Mailing address
PO BOX 5371, 4800 SAND POINT WAY NE, SEATTLE, WA 98145-5005
(206) 987-2106
(206) 987-5105
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD00014612
WA
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
MD00014612
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0826
INTERNAL ID-MOTOR VEHICLE ID
—
05
—
8362105
—
WA
Enumeration date
10/17/2006
Last updated
06/18/2018
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