Provider Demographics
NPI:1942390810
Name:TOMKINS, MICHAEL J (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:TOMKINS
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 1:1112 6TH AVE
Mailing Address - Street 2:STE 100
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-4048
Mailing Address - Country:US
Mailing Address - Phone:253-403-1444
Mailing Address - Fax:
Practice Address - Street 1:311 S L ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-3720
Practice Address - Country:US
Practice Address - Phone:253-403-1444
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-13
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000351722080A0000X
WAMD00035182207R00000X, 2080C0008X, 2080P0204X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2080C0008XAllopathic & Osteopathic PhysiciansPediatricsChild Abuse Pediatrics
No2080P0204XAllopathic & Osteopathic PhysiciansPediatricsPediatric Emergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA115903OtherL & I
911019392OtherCOMMERCIAL
WATO4710OtherREGENCE
22554OtherGROUP HEALTH
WA8209793Medicaid
WA8209793OtherCHPW
WATO4710OtherREGENCE
911019392OtherCOMMERCIAL
AB15604Medicare ID - Type UnspecifiedRR MEDICARE