Provider Demographics
NPI:1891359543
Name:FITZPATRICK, THOMAS SHEA (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:SHEA
Last Name:FITZPATRICK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 3RD AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98104-2697
Mailing Address - Country:US
Mailing Address - Phone:206-744-1599
Mailing Address - Fax:206-744-1554
Practice Address - Street 1:206 3RD AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104
Practice Address - Country:US
Practice Address - Phone:206-744-1599
Practice Address - Fax:206-744-1554
Is Sole Proprietor?:No
Enumeration Date:2019-04-29
Last Update Date:2019-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program