Provider Demographics
NPI:1427274349
Name:VARGHESE, THOMAS K JR (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:K
Last Name:VARGHESE
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17124 SE 48TH CT
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98006-5813
Mailing Address - Country:US
Mailing Address - Phone:425-502-7611
Mailing Address - Fax:
Practice Address - Street 1:UNIV OF WASHINGTON DIVISION OF CARDIOTHORACIC SURGERY
Practice Address - Street 2:BOX 356310
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:206-543-3093
Practice Address - Fax:206-543-0325
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2021-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301086400208600000X
WAMD00048455208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8485492Medicaid
WA8485492Medicaid
WA8867844Medicare PIN