Basic Information
| Provider Information | |||||||||
| NPI: | 1992744494 | ||||||||
| EntityType: | 2 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | PHILLIP THOMPSON DC INC PS | ||||||||
| LastName: | |||||||||
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| OtherOrganizationName: | THOMPSON CHIROPRACTIC | ||||||||
| OtherOrganizationType: | 3 | ||||||||
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| Mailing Information | |||||||||
| Address1: | 914 D ST NE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | AUBURN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980024163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2539390906 | ||||||||
| FaxNumber: | 2539393381 | ||||||||
| Practice Location | |||||||||
| Address1: | 914 D ST NE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | AUBURN | ||||||||
| State: | WA | ||||||||
| PostalCode: | 980024163 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2539390906 | ||||||||
| FaxNumber: | 2539393381 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 08/22/2020 | ||||||||
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| AuthorizedOfficialLastName: | THOMPSON | ||||||||
| AuthorizedOfficialFirstName: | MELANIE | ||||||||
| AuthorizedOfficialMiddleName: | P | ||||||||
| AuthorizedOfficialTitleorPosition: | OFFICE MANAGER/V. PRESIDENT | ||||||||
| AuthorizedOfficialTelephone: | 2539390906 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 111N00000X | UBI: 602 101 394 000 | WA | Y | 193200000X MULTI-SPECIALTY GROUP | Chiropractic Providers | Chiropractor |
No ID Information.