Provider Demographics
NPI:1164539425
Name:WESTHUSING, THOMAS KEVIN (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:KEVIN
Last Name:WESTHUSING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 N 14TH AVE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:PASCO
Mailing Address - State:WA
Mailing Address - Zip Code:99301-4187
Mailing Address - Country:US
Mailing Address - Phone:509-545-6220
Mailing Address - Fax:509-547-0894
Practice Address - Street 1:1200 N 14TH AVE
Practice Address - Street 2:SUITE 400
Practice Address - City:PASCO
Practice Address - State:WA
Practice Address - Zip Code:99301-4182
Practice Address - Country:US
Practice Address - Phone:509-545-6220
Practice Address - Fax:509-547-0894
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2016-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001712207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8413452Medicaid
H78527Medicare UPIN
WA8413452Medicaid