Provider Demographics
NPI:1114085420
Name:THOMPSON, GINA RENEE (MD)
Entity Type:Individual
Prefix:DR
First Name:GINA
Middle Name:RENEE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GINA
Other - Middle Name:RENEE
Other - Last Name:BIGGS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1019 21ST ST
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-2515
Mailing Address - Country:US
Mailing Address - Phone:360-299-0965
Mailing Address - Fax:360-299-4372
Practice Address - Street 1:1019 21ST ST
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-2515
Practice Address - Country:US
Practice Address - Phone:360-299-0965
Practice Address - Fax:360-299-4372
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-05
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000312652084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG08072Medicare UPIN