Individual
DR. THOMAS L. MITCHELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
25022 104TH AVE SE, STE D, KENT, WA 98030-2822
(253) 859-1911
(253) 859-5084
Mailing address
25022 104TH AVE SE, STE D, KENT, WA 98030-2822
(253) 859-1911
(253) 859-5084
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0D00003501
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1679601512
GROUP NPI
WA
Enumeration date
11/07/2005
Last updated
11/15/2012
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