Healthcare Provider Details

I. General information

NPI: 1780673392
Provider Name (Legal Business Name): THOMAS ANTHONY LAMPERTI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/17/2005
Last Update Date: 10/19/2021
Certification Date: 10/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 MADISON ST SUITE 700
SEATTLE WA
98104-1306
US

IV. Provider business mailing address

1101 MADISON ST SUITE 700
SEATTLE WA
98104-1306
US

V. Phone/Fax

Practice location:
  • Phone: 206-505-1300
  • Fax: 206-505-1258
Mailing address:
  • Phone: 206-505-1300
  • Fax: 206-505-1258

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number60135833
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number60135833
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: