Provider Demographics
NPI:1871646083
Name:THOMAS, MICHAEL (LMFT)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:THOMAS
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2370 130TH AVE NE STE 106
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-1770
Mailing Address - Country:US
Mailing Address - Phone:425-885-2833
Mailing Address - Fax:425-885-2833
Practice Address - Street 1:2370 130TH AVE NE STE 106
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-1770
Practice Address - Country:US
Practice Address - Phone:425-885-2833
Practice Address - Fax:425-885-2833
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00001354101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health