Provider Demographics
NPI:1255472320
Name:ADAMS, THOMAS J (MDIV, MA)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:J
Last Name:ADAMS
Suffix:
Gender:M
Credentials:MDIV, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5603 W 15TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99338-2303
Mailing Address - Country:US
Mailing Address - Phone:818-640-1261
Mailing Address - Fax:509-497-0896
Practice Address - Street 1:8121 W QUINAULT AVE STE F202
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99336-8210
Practice Address - Country:US
Practice Address - Phone:818-640-1261
Practice Address - Fax:509-497-0896
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2022-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60229702106H00000X
CAMFC45852106H00000X, 251S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No251S00000XAgenciesCommunity/Behavioral Health