Individual
DR. THOMAS JAMES LUETKEHANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3417 ENSIGN RD NE, OLYMPIA, WA 98506-5075
(360) 493-4609
(360) 493-4603
Mailing address
19020 33RD AVE W STE 210, LYNNWOOD, WA 98036-4748
(425) 563-1500
(425) 563-1374
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
MD00029619
WA
2085R0204X
Vascular & Interventional Radiology Physician
Primary
MD00029619
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0384820
L&I-RADIA
WA
01
—
078229
L&I-SOUTH SOUND RADIOLOGY
WA
05
—
1045797
—
WA
05
—
8137457
—
WA
Enumeration date
11/04/2005
Last updated
10/08/2020
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