Provider Demographics
NPI:1427710185
Name:THURSTON INTERNAL MEDICINE PLLC
Entity type:Organization
Organization Name:THURSTON INTERNAL MEDICINE PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OF ENTITY
Authorized Official - Prefix:
Authorized Official - First Name:TUI
Authorized Official - Middle Name:A
Authorized Official - Last Name:LAUILEFUE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-225-6883
Mailing Address - Street 1:420 MCPHEE RD SW STE C
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-4070
Mailing Address - Country:US
Mailing Address - Phone:360-382-2762
Mailing Address - Fax:360-282-0736
Practice Address - Street 1:420 MCPHEE RD SW STE C
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-4070
Practice Address - Country:US
Practice Address - Phone:360-382-2762
Practice Address - Fax:360-282-0736
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-10-11
Last Update Date:2021-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty