Provider Demographics
NPI:1578606216
Name:THOMPSON, BELINDA DAISY (LMP)
Entity Type:Individual
Prefix:
First Name:BELINDA
Middle Name:DAISY
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 186TH PL SE
Mailing Address - Street 2:#E101
Mailing Address - City:BOTHELL
Mailing Address - State:WA
Mailing Address - Zip Code:98012-8728
Mailing Address - Country:US
Mailing Address - Phone:206-227-9335
Mailing Address - Fax:425-481-3223
Practice Address - Street 1:20202 BALLINGER WAY NE
Practice Address - Street 2:
Practice Address - City:SHORELINE
Practice Address - State:WA
Practice Address - Zip Code:98155-1144
Practice Address - Country:US
Practice Address - Phone:206-227-9335
Practice Address - Fax:425-481-3223
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00006431174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist