Individual
STANLEY KENNETH THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
111 S 13TH ST, MOUNT VERNON, WA 98274-4105
(360) 336-2178
Mailing address
PO BOX 2329, MOUNT VERNON, WA 98273-7329
(360) 336-6517
(360) 466-2682
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30000120
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0068328
DEPARTMENT OF LAOBR AND INDUSTRIES
WA
01
—
06755
REGENCE BLUE SHIELD
WA
01
—
430018589
RAILROAD MEDICARE
WA
05
—
9604257
—
WA
01
—
TH4255
REGENCE BLUE SHIELD
WA
Enumeration date
07/12/2006
Last updated
05/23/2008
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