Provider Demographics
NPI:1366486540
Name:THOMAS, SYLVIA (MD)
Entity Type:Individual
Prefix:
First Name:SYLVIA
Middle Name:
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5920 100TH ST SW
Mailing Address - Street 2:31
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2751
Mailing Address - Country:US
Mailing Address - Phone:253-584-3023
Mailing Address - Fax:253-582-1222
Practice Address - Street 1:5920 100TH ST. SW
Practice Address - Street 2:#31
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-0000
Practice Address - Country:US
Practice Address - Phone:253-584-3023
Practice Address - Fax:253-582-1222
Is Sole Proprietor?:No
Enumeration Date:2006-06-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00040158207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8295784Medicaid
WAG8850855Medicare ID - Type UnspecifiedMEDICARE ID NUMBER
WAF88297Medicare UPIN