Provider Demographics
NPI:1477760916
Name:THOMPSON, GARRICK (LMP)
Entity type:Individual
Prefix:
First Name:GARRICK
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4215 N ELLA RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99212-1839
Mailing Address - Country:US
Mailing Address - Phone:509-953-5850
Mailing Address - Fax:509-534-6821
Practice Address - Street 1:4215 N ELLA RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99212-1839
Practice Address - Country:US
Practice Address - Phone:509-953-5850
Practice Address - Fax:509-534-6821
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2025-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00014322174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0145024OtherWA LABOR & INDUSTRIES