Provider Demographics
NPI:1235202862
Name:THOMAS, LAWRENCE A (DC)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:A
Last Name:THOMAS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:LARRY
Other - Middle Name:A
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DC
Mailing Address - Street 1:1101 BOYLSTON AVE STE A
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-2818
Mailing Address - Country:US
Mailing Address - Phone:206-623-5202
Mailing Address - Fax:
Practice Address - Street 1:1101 BOYLSTON AVE STE A
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2818
Practice Address - Country:US
Practice Address - Phone:206-623-5202
Practice Address - Fax:206-623-0995
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2021-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002339111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA62071OtherLABOR & INDUSTRIES
WA350051503OtherRAILROAD MEDICARE
WAG000108456Medicare PIN
WA350051503OtherRAILROAD MEDICARE