MEDICARE: DR. THOMAS J. MUELLER MD

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	174400000X	Specialist	MD00025076	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	R32456	OTHER	WA	REGENCE

General Provider Information

NPI Number	:	1790869030
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. THOMAS J. MUELLER MD

Provider Business Mailing Address
First Line	:	5929 EVERGREEN WAY
Second Line	:	SUITE 200
City	:	EVERETT
State	:	WA
Zip	:	98203-6031
Country	:	US
Telephone Number	:	425-258-4361
Fax Number	:	425-259-5270

Provider Business Practice Location Address
First Line	:	5929 EVERGREEN WAY
Second Line	:	SUITE 200
City	:	EVERETT
State	:	WA
Zip	:	98203-6031
Country	:	US
Telephone Number	:	425-258-4361
Fax Number	:	425-259-5270

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

Provider Enumeration Date	:	10/24/2006
Last Update Date	:	01/07/2011

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