Individual
SUSAN E THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 W TIETAN ST, WALLA WALLA, WA 99362-4445
(509) 525-3720
(509) 522-1588
Mailing address
55 W TIETAN ST, WALLA WALLA, WA 99362-4445
(509) 525-3720
(509) 522-1592
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00024761
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1029388
—
WA
01
—
110055232
RAIL ROAD MEDICARE
WA
05
—
155341
—
OR
01
—
30245
L&I
WA
Enumeration date
02/16/2006
Last updated
04/10/2014
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