Provider Demographics
NPI:1326457508
Name:FIELD, THOMAS ANDREW (PHD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:ANDREW
Last Name:FIELD
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 OAKESDALE AVE SW
Mailing Address - Street 2:STE 104
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-5226
Mailing Address - Country:US
Mailing Address - Phone:425-228-5336
Mailing Address - Fax:425-228-4540
Practice Address - Street 1:5837 221ST PL SE
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-8917
Practice Address - Country:US
Practice Address - Phone:425-391-0887
Practice Address - Fax:425-391-7014
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-12
Last Update Date:2014-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH60442969101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health