Provider Demographics
NPI:1982734794
Name:SAWYER, THOMAS JASON (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:JASON
Last Name:SAWYER
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 1:1536 N 115TH ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-8400
Mailing Address - Country:US
Mailing Address - Phone:206-363-1004
Mailing Address - Fax:206-363-3548
Practice Address - Street 1:1536 N 115TH ST
Practice Address - Street 2:SUITE 200
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-8400
Practice Address - Country:US
Practice Address - Phone:206-363-1004
Practice Address - Fax:206-363-3548
Is Sole Proprietor?:No
Enumeration Date:2007-03-07
Last Update Date:2010-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT042242207RC0000X
WAMD00048521207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8513871Medicaid
WA8513871Medicaid