MEDICARE: THE TRANSFORMATION CLINIC, PLLC

Medicare Provider Information

Scope of Practice

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

#	Taxonomy Code	Taxonomy
1	207Q00000X	Family Medicine Physician
2	207R00000X	Internal Medicine Physician
3	208000000X	Pediatrics Physician
4	2084P0800X	Psychiatry Physician

General Provider Information

NPI Number	:	1992661086
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	THE TRANSFORMATION CLINIC, PLLC

Provider Business Mailing Address
First Line	:	1329 N 47TH ST UNIT 31022
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-6765
Country	:	US
Telephone Number	:	253-448-3609
Fax Number	:

Provider Business Practice Location Address
First Line	:	1329 N 47TH ST UNIT 31022
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98103-6765
Country	:	US
Telephone Number	:	253-448-3609
Fax Number	:

Authorized Official
Title or Position	:	PHYSICIAN OWNER
Name	:	DR. JANE THOMAS-TRAN
Credential	:	MD
Telephone Number	:	253-448-3609

Provider Enumeration Date	:	01/02/2026
Last Update Date	:	01/02/2026

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