MEDICARE: MICHAEL LAUCKNER THOMAS LMHCA, MT-BC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225A00000X	Music Therapist
2	101YM0800X	Mental Health Counselor	MC61163620	WA

General Provider Information

NPI Number	:	1750776456
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL LAUCKNER THOMAS LMHCA, MT-BC

Provider Business Mailing Address
First Line	:	5620 112TH ST E STE 215
Second Line	:
City	:	PUYALLUP
State	:	WA
Zip	:	98373-3206
Country	:	US
Telephone Number	:	253-446-7176
Fax Number	:

Provider Business Practice Location Address
First Line	:	5620 112TH ST E STE 215
Second Line	:
City	:	PUYALLUP
State	:	WA
Zip	:	98373-3206
Country	:	US
Telephone Number	:	253-446-7176
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/31/2015
Last Update Date	:	05/11/2021

Similar Medicare Providers

1063060416 — JESSICA METZGER M.A.
Practice Location Address:

5620 112TH ST E STE 215
PUYALLUP, WA
98373-3206

Practice Phone: 253-446-7176
Practice Fax:

1952582843 — MR. BRYCE WILSON MA, LMHC, LMFT
Practice Location Address:

5620 112TH ST E , STE. 215
PUYALLUP, WA
98373-3206

Practice Phone: 253-446-7176
Practice Fax:

1447630116 — THOMAS HENRY DDS PS DBA CANYON ORTHODONTICS
Practice Location Address:

5620 112TH ST E , SUITE 255
PUYALLUP, WA
98373-3206

Practice Phone: 253-256-4000
Practice Fax: 253-770-9638

1770954463 — MICHELLE BAKER LMHC, CMHS, MHP
Practice Location Address:

5620 112TH ST E STE 215
PUYALLUP, WA
98373-3206

Practice Phone: 253-446-7176
Practice Fax:

1891158317 — KORSMO & HENRY DDD PS
Practice Location Address:

5620 112TH ST E , SUITE 250
PUYALLUP, WA
98373-3206

Practice Phone: 253-770-0529
Practice Fax: 253-770-9638

1154770329 — BRYCE WILSON, PLLC
Practice Location Address:

5620 112TH ST E , STE. 215
PUYALLUP, WA
98373-3206

Practice Phone: 253-446-7176
Practice Fax: 253-446-7176

Directions to “ MICHAEL LAUCKNER THOMAS LMHCA, MT-BC” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.