Basic Information
Provider Information
NPI: 1023103033
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THAI
FirstName: DON
MiddleName: Q.
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 34876
Address2:  
City: SEATTLE
State: WA
PostalCode: 981241876
CountryCode: US
TelephoneNumber: 4256565412
FaxNumber: 4256564096
Practice Location
Address1: 3915 TALBOT RD S
Address2: STE 104
City: RENTON
State: WA
PostalCode: 980555738
CountryCode: US
TelephoneNumber: 4259176218
FaxNumber: 4259176287
Other Information
ProviderEnumerationDate: 10/04/2006
LastUpdateDate: 09/25/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084N0400XMD00033544WAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
2084N0402XMD00033544WAN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology with Special Qualifications in Child Neurology

No ID Information.


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