Healthcare Provider Details

I. General information

NPI: 1841145794
Provider Name (Legal Business Name): THOMAS EDWARD FREELS FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/04/2026
Last Update Date: 03/09/2026
Certification Date: 03/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 91ST AVE NE
LAKE STEVENS WA
98258-2420
US

IV. Provider business mailing address

PO BOX 31001-4141
PASADENA CA
91110-0001
US

V. Phone/Fax

Practice location:
  • Phone: 888-227-3312
  • Fax:
Mailing address:
  • Phone: 888-227-3312
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAP70087450
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: