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General NPI Number Information
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NPI Number | 1376656363
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Entity Type | Individual
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Provider Name | PETER M THOMAS PHD
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Gender | Male
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Dates
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Enumeration Date | 08/16/2006
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Last Update Date | 05/11/2022
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Provider Practice Location Address
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Address Line | 4649 SUNNYSIDE AVE N SUITE 300
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City | SEATTLE
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State | WA
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Zip | 98103-6900
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Country | US
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Telephone | 206-634-2162
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Fax | 206-417-2841
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Provider Business Mailing Address
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Address Line | 19018 CORLISS AVE N
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City | SHORELINE
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State | WA
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Zip | 98133-4146
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Country | US
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Telephone | 206-356-8724
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Fax | 206-417-2841
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 1172
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License Number State | WA
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