Healthcare Provider Details

I. General information

NPI: 1821081407
Provider Name (Legal Business Name): THOMAS FRANK GUMPRECHT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2005
Last Update Date: 10/24/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8301 161ST AVE NE SUITE 200
REDMOND WA
98052-3858
US

IV. Provider business mailing address

805 MADISON ST SUITE 901
SEATTLE WA
98104-1172
US

V. Phone/Fax

Practice location:
  • Phone: 425-869-4855
  • Fax: 425-869-4858
Mailing address:
  • Phone: 206-264-8100
  • Fax: 206-264-8689

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberMD00015217
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: