Provider Demographics
NPI:1790860591
Name:BOWDLE, THOMAS ANDREW (MD, PHD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:ANDREW
Last Name:BOWDLE
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:T.
Other - Middle Name:ANDREW
Other - Last Name:BOWDLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 50095
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98145-5095
Mailing Address - Country:US
Mailing Address - Phone:206-543-6420
Mailing Address - Fax:
Practice Address - Street 1:UNIVERSITY OF WASHINGTON MEDICAL CTR
Practice Address - Street 2:1959 NE PACIFIC ST
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:206-598-4260
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-27
Last Update Date:2022-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00019307207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0230845OtherL&I
WA1790860591Medicaid
4754OtherINTERNAL ID-MOTOR VEHICLE ID
4754OtherINTERNAL ID-MOTOR VEHICLE ID
F05907Medicare UPIN