Healthcare Provider Details

I. General information

NPI: 1144760992
Provider Name (Legal Business Name): JAMES M. THOMAS, P.S.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/27/2017
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 112TH AVE NE C250
BELLEVUE WA
98004-3732
US

IV. Provider business mailing address

1200 112TH AVE NE C250
BELLEVUE WA
98004-3732
US

V. Phone/Fax

Practice location:
  • Phone: 425-208-6485
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223P0221X
TaxonomyPediatric Dentistry
License NumberDE00010125
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name: DR. JAMES M THOMAS
Title or Position: OWNER
Credential: D.D.S, M.S., P.S.
Phone: 425-310-8430