Individual
JEFFREY W THURSTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
6212 75TH ST W, SUITE 1, LAKEWOOD, WA 98499-8368
(253) 983-1539
(253) 588-2693
Mailing address
6212 75TH ST W, SUITE 1, LAKEWOOD, WA 98499-8368
(253) 983-1539
(253) 588-2693
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30002150
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP30002150
ARNP LICENSE
WA
01
—
RN00085153
REGISTERED NURSE LICENSE
WA
Enumeration date
12/29/2006
Last updated
09/14/2011
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