Provider Demographics
NPI:1326051129
Name:THOMAS, MICHAEL GE (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:GE
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:MICHAEL
Other - Middle Name:
Other - Last Name:THOMAS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:1400 E. KINCAID STREET
Mailing Address - Street 2:ATTN: CREDENTIALING
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4127
Mailing Address - Country:US
Mailing Address - Phone:360-428-2500
Mailing Address - Fax:360-428-6485
Practice Address - Street 1:2320 FREEWAY DRIVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273
Practice Address - Country:US
Practice Address - Phone:360-814-6800
Practice Address - Fax:360-814-6917
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD185536207X00000X
WAMD00035605207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
7573047OtherAETNA
WA1104959Medicaid
WA230400OtherLABOR & INDUSTRIES
2512THOtherREGENCE
WA8951289OtherL&I CRIME VICTIMS COMPENSATION PROGRAM
WA8226870Medicaid
P00626752OtherRAILROAD MEDICARE
WATH0246OtherBLUE SHIELD
WA124120OtherLABOR & INDUSTRY
WA124120OtherLABOR & INDUSTRY
WA8226870Medicaid
G8900015Medicare PIN
P00626752OtherRAILROAD MEDICARE
WA8951289OtherL&I CRIME VICTIMS COMPENSATION PROGRAM
BT5631521OtherDEA
WATH0246OtherBLUE SHIELD
G8872908Medicare PIN
G8900014Medicare PIN