Provider Demographics
NPI:1457461188
Name:FRAZER, THOMAS A (MD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:FRAZER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:THOMAS
Other - Middle Name:S
Other - Last Name:FRAZER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4755 FAUNTLEROY WAY SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-4647
Mailing Address - Country:US
Mailing Address - Phone:206-201-0551
Mailing Address - Fax:253-274-7929
Practice Address - Street 1:4755 FAUNTLEROY WAY SW
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98116-4647
Practice Address - Country:US
Practice Address - Phone:206-201-0551
Practice Address - Fax:253-274-7929
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2022-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC28824207Q00000X
WAMD00047617207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1060349Medicaid
WA10917008OtherCAQH
WA8865940OtherMC PTAN