Individual
THOMAS TAE I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
3530 WILSHIRE BLVD STE 1200, LOS ANGELES, CA 90010-2343
(425) 273-8095
Mailing address
12640 DOUBLE EAGLE DR, MUKILTEO, WA 98275-5556
(425) 273-8095
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
NP95011784
CA
Other
Enumeration date
12/18/2018
Last updated
01/11/2023
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