Provider Demographics
NPI:1124564844
Name:SILBERBERGER, THOMAS (MS, ATC)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:
Last Name:SILBERBERGER
Suffix:
Gender:M
Credentials:MS, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:417 DALLAS ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-3002
Mailing Address - Country:US
Mailing Address - Phone:425-760-0601
Mailing Address - Fax:
Practice Address - Street 1:17023 11TH AVENUE NE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98259
Practice Address - Country:US
Practice Address - Phone:360-625-4507
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-01-19
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA1 60589652207PS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PS0010XAllopathic & Osteopathic PhysiciansEmergency MedicineSports Medicine