Individual
MICHELLE MARGARET HANWAY THURMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
16515 MERIDIAN E, SUITE 104A, PUYALLUP, WA 98375-6251
(253) 697-3030
(253) 697-8190
Mailing address
PO BOX 40, PUYALLUP, WA 98371-0137
(253) 697-5502
(253) 697-5510
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00042314
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0171135
L & I PROVIDER NUMBER
WA
01
—
1896TH
REGENCE RIDER NUMBER
WA
01
—
7247466
AETNA PROVIDER NUMBER
WA
05
—
8374175
—
WA
01
—
911203494AA
KPS PROVIDER NUMBER
WA
01
—
98375B014
TRICARE PROVIDER NUMBER
WA
Enumeration date
06/06/2006
Last updated
08/18/2011
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