Individual
ATUL THAKKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1720 COOKS HILL RD, CENTRALIA, WA 98531-9071
(360) 736-1195
(360) 736-4952
Mailing address
1720 COOKS HILL RD, CENTRALIA, WA 98531-9071
(360) 736-1195
(360) 736-4952
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD00035008
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0115053
LABOR & INDUSTRIES
WA
01
—
20036716
RR MEDICARE
—
05
—
8209876
—
WA
Enumeration date
05/03/2006
Last updated
04/08/2021
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