Basic Information
Provider Information
NPI: 1023084761
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BIEHL
FirstName: THOMAS
MiddleName: R
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1100 OLIVE WAY
Address2: MS: M4-PA
City: SEATTLE
State: WA
PostalCode: 981011873
CountryCode: US
TelephoneNumber: 2065155811
FaxNumber:  
Practice Location
Address1: 1100 9TH AVE
Address2:  
City: SEATTLE
State: WA
PostalCode: 981012756
CountryCode: US
TelephoneNumber: 2062236600
FaxNumber: 2065155886
Other Information
ProviderEnumerationDate: 02/23/2006
LastUpdateDate: 04/09/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208600000XMD00027098WAY Allopathic & Osteopathic PhysiciansSurgery 

ID Information
IDTypeStateIssuerDescription
02003884301WARAILROAD MEDICAREOTHER
003958801WAL&IOTHER
MD982705AK MEDICAID
BI029701WAINDIVIDUAL BLUE SHIELDOTHER
821106205WA MEDICAID


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