Provider Demographics
NPI:1861794992
Name:GRIFFIN, THOMAS WARD
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:WARD
Last Name:GRIFFIN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3620 E PROSPECT ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-4440
Mailing Address - Country:US
Mailing Address - Phone:206-322-6742
Mailing Address - Fax:206-322-6803
Practice Address - Street 1:3620 E PROSPECT ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-4440
Practice Address - Country:US
Practice Address - Phone:206-322-6742
Practice Address - Fax:206-322-6803
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-22
Last Update Date:2010-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000135072085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology