Healthcare Provider Details

I. General information

NPI: 1124564844
Provider Name (Legal Business Name): THOMAS SILBERBERGER M.S., A.T.C.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2017
Last Update Date: 01/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17023 11TH AVENUE NE
ARLINGTON WA
98259
US

IV. Provider business mailing address

417 DALLAS ST
MOUNT VERNON WA
98274-3002
US

V. Phone/Fax

Practice location:
  • Phone: 360-625-4507
  • Fax:
Mailing address:
  • Phone: 425-760-0601
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207PS0010X
TaxonomySports Medicine (Emergency Medicine) Physician
License NumberA1 60589652
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: