Provider Demographics
NPI:1013232990
Name:JEFFREY W. THURSTON ARNP, INC.
Entity Type:Organization
Organization Name:JEFFREY W. THURSTON ARNP, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRICT NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:JEFFREY
Authorized Official - Middle Name:W
Authorized Official - Last Name:THURSTON
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:253-983-1539
Mailing Address - Street 1:6212 75TH ST W
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-8368
Mailing Address - Country:US
Mailing Address - Phone:253-983-1539
Mailing Address - Fax:253-588-2693
Practice Address - Street 1:6212 75TH ST W
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-8368
Practice Address - Country:US
Practice Address - Phone:253-983-1539
Practice Address - Fax:253-588-2693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-04-02
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP 30002150363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty