Provider Demographics
NPI:1659547495
Name:RADEMACHER, THOMAS LEE (DO)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:LEE
Last Name:RADEMACHER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 W 5TH AVE STE 230E
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-4808
Mailing Address - Country:US
Mailing Address - Phone:509-838-5361
Mailing Address - Fax:509-835-4058
Practice Address - Street 1:104 W 5TH AVE STE 230E
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-4808
Practice Address - Country:US
Practice Address - Phone:509-838-5361
Practice Address - Fax:509-835-4058
Is Sole Proprietor?:No
Enumeration Date:2008-05-01
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP 00002350207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8510950Medicaid