Individual
JOHN THOMAS FREDERICK
Active
Individual
JOHN THOMAS FREDERICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD00036632
WA
2084P0805X
Geriatric Psychiatry Physician
MD00036632
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0163635
VM LABOR AND INDUSTRIES #
WA
01
—
3015FR
VM BLUE SHIELD #
WA
05
—
8286858
—
WA
01
—
8883129
MEDICARE - SNO CO
WA
01
—
P00444827
VM RAILROAD MC #
WA
01
—
US7536792
VM AETNA PCP PIN
WA
Enumeration date
02/15/2007
Last updated
02/20/2018
Update your record
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