Provider Demographics
NPI:1417965419
Name:THOMPSON, DON LEWIS (DC)
Entity Type:Individual
Prefix:MR
First Name:DON
Middle Name:LEWIS
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:909 W 13TH ST
Mailing Address - Street 2:#2
Mailing Address - City:BENTON CITY
Mailing Address - State:WA
Mailing Address - Zip Code:99320
Mailing Address - Country:US
Mailing Address - Phone:509-588-6802
Mailing Address - Fax:
Practice Address - Street 1:909 W 13TH ST
Practice Address - Street 2:#2
Practice Address - City:BENTON CITY
Practice Address - State:WA
Practice Address - Zip Code:99320
Practice Address - Country:US
Practice Address - Phone:509-588-6802
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00001817111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
19317OtherL AND I
T02404Medicare UPIN