Provider Demographics
NPI:1588977870
Name:THOMPSON, GLENNA LOUISE (CPHT)
Entity type:Individual
Prefix:MISS
First Name:GLENNA
Middle Name:LOUISE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 16TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-5226
Mailing Address - Country:US
Mailing Address - Phone:206-326-3181
Mailing Address - Fax:
Practice Address - Street 1:1100 FAIRVIEW AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-4433
Practice Address - Country:US
Practice Address - Phone:206-667-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-15
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA60131101183700000X, 247200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician
No247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAVA60131101OtherWA DEPARTMENT OF HEALTH