Individual
ELIZABETH HEASTON THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD00003815
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0174418
WA LABOR AND INDUSTRY
WA
01
—
11102
GROUP HEALTH
—
05
—
2029932
—
WA
01
—
BLUE CROSS BLUE SHIE
8890HE
—
01
—
G319211100
MEDICARE
WA
01
—
P00082765
RAILROAD MEDICARE
—
Enumeration date
07/21/2006
Last updated
02/04/2008
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