Provider Demographics
NPI:1043771942
Name:MCCOWN, THOMAS MICHAEL JR (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:MICHAEL
Last Name:MCCOWN
Suffix:JR
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1902 A ST SE APT C308
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98002-6683
Mailing Address - Country:US
Mailing Address - Phone:206-696-5666
Mailing Address - Fax:
Practice Address - Street 1:26004 104TH AVE SE
Practice Address - Street 2:
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98030-7677
Practice Address - Country:US
Practice Address - Phone:800-422-2844
Practice Address - Fax:877-514-9952
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2024-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP61316851207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine