Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XS0117X | Orthopaedic Spine Surgeon | MD00043489 | WA |
NPI | 1134189855 |
---|---|
Provider Name | Dr. Jason H Thompson |
First Address | Seattle, WA 98104-1172 |
Second Address | Renton, WA 98055-5773 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/03/2006 |
Last Update Date | 07/10/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I03257 | (02) | WA |