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General NPI Number Information
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NPI Number | 1043771942
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Entity Type | Individual
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Provider Name | THOMAS MICHAEL MCCOWN JR. DO
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Gender | Male
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Dates
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Enumeration Date | 03/26/2019
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Last Update Date | 04/24/2024
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Provider Practice Location Address
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Address Line | 26004 104TH AVE SE
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City | KENT
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State | WA
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Zip | 98030-7677
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Country | US
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Telephone | 800-422-2844
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Fax | 877-514-9952
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Provider Business Mailing Address
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Address Line | 1902 A ST SE APT C308
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City | AUBURN
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State | WA
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Zip | 98002-6683
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Country | US
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Telephone | 206-696-5666
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OP61316851
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License Number State | WA
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