Provider Demographics
NPI:1558447276
Name:THOMAS, JULIE MYERS (MD)
Entity Type:Individual
Prefix:
First Name:JULIE
Middle Name:MYERS
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 1:515 MINOR AVE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2120
Mailing Address - Country:US
Mailing Address - Phone:206-386-9500
Mailing Address - Fax:206-576-3802
Practice Address - Street 1:3236 78TH AVE SE
Practice Address - Street 2:STE 200
Practice Address - City:MERCER ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98040-3500
Practice Address - Country:US
Practice Address - Phone:206-275-5060
Practice Address - Fax:206-275-5061
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037996207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
2000423OtherINTERNAL ID-MOTOR VEHICLE ID
WA110236123OtherRAILROAD MEDICARE
WA245772OtherLNI
WA8248916Medicaid
WA4767THOtherREGENCE
WAP00773104OtherPALMETTO RR MEDICARE
AB28460Medicare ID - Type Unspecified
WA4767THOtherREGENCE
WAP00773104OtherPALMETTO RR MEDICARE
WA8248916Medicare PIN
WAAB29943Medicare PIN