Provider Demographics
NPI:1215185749
Name:THOMAS, BERNADETTE AMBROSE (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNADETTE
Middle Name:AMBROSE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1130 N 185TH ST STE 201
Mailing Address - Street 2:
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-4011
Mailing Address - Country:US
Mailing Address - Phone:206-542-1000
Mailing Address - Fax:206-542-5353
Practice Address - Street 1:1130 N 185TH ST STE 201
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98133
Practice Address - Country:US
Practice Address - Phone:206-542-1000
Practice Address - Fax:206-542-5353
Is Sole Proprietor?:No
Enumeration Date:2008-09-09
Last Update Date:2019-11-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD60042360207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology