Provider Demographics
NPI:1700053790
Name:THOMAS J DEAL MD
Entity Type:Organization
Organization Name:THOMAS J DEAL MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:J
Authorized Official - Last Name:DEAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:206-789-5555
Mailing Address - Street 1:5343 TALLMAN AVE NW
Mailing Address - Street 2:203
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3931
Mailing Address - Country:US
Mailing Address - Phone:206-789-5555
Mailing Address - Fax:206-789-5699
Practice Address - Street 1:5343 TALLMAN AVE NW
Practice Address - Street 2:203
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98107-3931
Practice Address - Country:US
Practice Address - Phone:206-789-5555
Practice Address - Fax:206-789-5699
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00016837207QA0401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAB10809Medicare PIN