Provider Demographics
NPI:1558666875
Name:DR.KATHRYN S.THOMPSON & ASSOCIATES
Entity Type:Organization
Organization Name:DR.KATHRYN S.THOMPSON & ASSOCIATES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:RUSNA
Authorized Official - Middle Name:Y
Authorized Official - Last Name:DUNGAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:425-712-8443
Mailing Address - Street 1:2701 184TH ST SW STE 109
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98037-4739
Mailing Address - Country:US
Mailing Address - Phone:425-712-8443
Mailing Address - Fax:425-712-0988
Practice Address - Street 1:2701 184TH ST SW STE 109
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98037-4739
Practice Address - Country:US
Practice Address - Phone:425-712-8443
Practice Address - Fax:425-712-0988
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-01-18
Last Update Date:2011-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD 00003381152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1265501431OtherNPI TYPE 1
WA1006355Medicaid
WAABG03440Medicare PIN
WA1006355Medicaid