Provider Demographics
NPI:1982777694
Name:THOMPSON, ANTHONY MICHAEL (LMP LAC)
Entity type:Individual
Prefix:MR
First Name:ANTHONY
Middle Name:MICHAEL
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:LMP LAC
Other - Prefix:
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Mailing Address - Street 1:14251 73RD AVE NE
Mailing Address - Street 2:A202
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98011
Mailing Address - Country:US
Mailing Address - Phone:206-229-3252
Mailing Address - Fax:
Practice Address - Street 1:17311 135TH AVE NE
Practice Address - Street 2:SUITE B300
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-3519
Practice Address - Country:US
Practice Address - Phone:425-737-6843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00002835171100000X
WAMA00010448225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171100000XOther Service ProvidersAcupuncturist
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist