Provider Demographics
NPI:1518288893
Name:THOMAS, JIMMY ABRAHAM (MBBS, MPH)
Entity Type:Individual
Prefix:DR
First Name:JIMMY
Middle Name:ABRAHAM
Last Name:THOMAS
Suffix:
Gender:M
Credentials:MBBS, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1400 E KINCAID ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-4127
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1415 E KINCAID ST
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98274-4126
Practice Address - Country:US
Practice Address - Phone:360-428-2550
Practice Address - Fax:360-814-8390
Is Sole Proprietor?:No
Enumeration Date:2010-06-21
Last Update Date:2021-10-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OK27778207RN0300X
WA60359656207RN0300X
ORMD171342207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine