Individual
THOMAS EDWARD PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1355 N 205TH ST, SHORELINE, WA 98133-3215
(206) 542-5656
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00016612
WA
207RG0100X
Gastroenterology Physician
MD00016612
WA
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
MD00016612
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
262220
INTERNAL ID-MOTOR VEHICLE ID
—
05
—
8329765
—
WA
Enumeration date
10/27/2006
Last updated
12/29/2010
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