Provider Demographics
NPI:1235183427
Name:BOYER, THOMAS (DO)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:
Last Name:BOYER
Suffix:
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 1:1509 8TH AVE W
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-3222
Mailing Address - Country:US
Mailing Address - Phone:206-285-1642
Mailing Address - Fax:
Practice Address - Street 1:2005 NW SAMMAMISH RD
Practice Address - Street 2:BLDG B100
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-5364
Practice Address - Country:US
Practice Address - Phone:425-394-0610
Practice Address - Fax:425-394-0611
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2008-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001705207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8389850Medicaid
WA8864375Medicare PIN
WA8389850Medicaid