Provider Demographics
NPI:1568514032
Name:LENART, THOMAS D (MD, PHD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:D
Last Name:LENART
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12333 NE 130TH LN STE 440
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-7467
Mailing Address - Country:US
Mailing Address - Phone:425-899-3838
Mailing Address - Fax:425-899-3844
Practice Address - Street 1:17130 AVONDALE WAY
Practice Address - Street 2:SUITE 111
Practice Address - City:REDMOND
Practice Address - State:WA
Practice Address - Zip Code:98052-4455
Practice Address - Country:US
Practice Address - Phone:425-885-6600
Practice Address - Fax:425-885-6580
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2021-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00037554207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA368014OtherWA LABOR & INDUSTRIES
WA2076040Medicaid
WAG42601Medicare UPIN