Provider Demographics
NPI:1700190063
Name:THOMPSON, JAN ALAIR (LCPO)
Entity Type:Individual
Prefix:
First Name:JAN
Middle Name:ALAIR
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:LCPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7942 NOBLE VIEW LN NW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98502-9629
Mailing Address - Country:US
Mailing Address - Phone:360-791-2207
Mailing Address - Fax:888-570-2341
Practice Address - Street 1:7942 NOBLE VIEW LN NW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-9629
Practice Address - Country:US
Practice Address - Phone:360-628-8265
Practice Address - Fax:888-570-2341
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-28
Last Update Date:2022-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPS00000056224P00000X
WAOI00000055222Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist