Basic Information
Provider Information
NPI: 1003805482
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: LANDINO
FirstName: THOMAS
MiddleName: M
NamePrefix:  
NameSuffix:  
Credential: DPM, FACFAS, PT
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1100 9TH AVE
Address2:  
City: SEATTLE
State: WA
PostalCode: 981012756
CountryCode: US
TelephoneNumber: 2065155811
FaxNumber: 2065155886
Practice Location
Address1: 33501 1ST WAY S
Address2:  
City: FEDERAL WAY
State: WA
PostalCode: 980036208
CountryCode: US
TelephoneNumber: 2538382400
FaxNumber: 2538741634
Other Information
ProviderEnumerationDate: 10/18/2005
LastUpdateDate: 05/12/2011
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
213E00000XPO60099671WAY Podiatric Medicine & Surgery Service ProvidersPodiatrist 
213ES0103X07001045AINN Podiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery

ID Information
IDTypeStateIssuerDescription
20086683005IN MEDICAID


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