Provider Demographics
NPI:1699794107
Name:NESS, THOMAS BRENT (DC)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:BRENT
Last Name:NESS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 NE RIDDELL RD
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-3039
Mailing Address - Country:US
Mailing Address - Phone:360-479-0331
Mailing Address - Fax:360-479-6766
Practice Address - Street 1:1111 NE RIDDELL RD
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-3039
Practice Address - Country:US
Practice Address - Phone:360-479-0331
Practice Address - Fax:360-479-6766
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2015-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002172111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA350025732OtherRAILROAD MEDICARE