Provider Demographics
NPI:1265505424
Name:RAFFERTY, THOMAS FRANCES (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:FRANCES
Last Name:RAFFERTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5130 CORPORATE CENTER CT SE
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-5957
Mailing Address - Country:US
Mailing Address - Phone:360-413-8600
Mailing Address - Fax:360-413-8822
Practice Address - Street 1:5130 CORPORATE CENTER CT SE
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-5957
Practice Address - Country:US
Practice Address - Phone:360-413-8600
Practice Address - Fax:360-413-8822
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00018161207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1265505424OtherNPI
WA8216509Medicaid
WA8216509Medicaid
WAA08575Medicare UPIN
WA1265505424OtherNPI