Provider Demographics
NPI:1497858419
Name:LATHROP, JAMES R (DNP - ARNP)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:R
Last Name:LATHROP
Suffix:
Gender:M
Credentials:DNP - ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 NAT WASHINGTON WAY
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:WA
Mailing Address - Zip Code:98823-1982
Mailing Address - Country:US
Mailing Address - Phone:509-754-4631
Mailing Address - Fax:
Practice Address - Street 1:1035 116TH AVENUE NE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004
Practice Address - Country:US
Practice Address - Phone:425-688-5759
Practice Address - Fax:425-688-5101
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA30004274207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9621897Medicaid
S56731Medicare UPIN
WA9621897Medicaid