Individual
JOHN WENDELL THORNBURG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8029 NE 169TH ST, KENMORE, WA 98028-3950
(425) 488-8298
Mailing address
8029 NE 169TH ST, KENMORE, WA 98028-3950
(425) 488-8298
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
WA
Other
Enumeration date
02/19/2025
Last updated
02/19/2025
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