Healthcare Provider Details

I. General information

NPI: 1073044863
Provider Name (Legal Business Name): MOLLY THOMPSON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/23/2017
Last Update Date: 08/04/2025
Certification Date: 08/04/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 SE BISHOP BLVD STE 401
PULLMAN WA
99163-5517
US

IV. Provider business mailing address

825 SE BISHOP BLVD STE 401
PULLMAN WA
99163-5517
US

V. Phone/Fax

Practice location:
  • Phone: 509-332-7720
  • Fax: 509-334-9247
Mailing address:
  • Phone: 509-332-7720
  • Fax: 505-715-2131

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD61059775
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: