Individual
THAMMASAK MINGBUNJERDSUK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 414-2000
(360) 414-7638
Mailing address
223 INDIANA AVE APT 3211, LUBBOCK, TX 79415-5369
(916) 436-6401
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD61202611
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/23/2016
Last updated
04/27/2022
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