Provider Demographics
NPI:1578861852
Name:THOMAS, GREGORY DAVID (RPH, MPH)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:DAVID
Last Name:THOMAS
Suffix:
Gender:M
Credentials:RPH, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3069 71ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:MERCER ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98040-2643
Mailing Address - Country:US
Mailing Address - Phone:206-230-6418
Mailing Address - Fax:
Practice Address - Street 1:401 5TH AVE
Practice Address - Street 2:KING COUNTY CNK-ES-0230
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-1818
Practice Address - Country:US
Practice Address - Phone:206-296-4637
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-10
Last Update Date:2011-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA168371835P1200X
FL205141835P1200X
MA173401835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy