THOMAS LEE ETHERTON


Address: 4425 Cole Ct Se, Olympia, WA 98501-4474
Phone: 3608702011

THOMAS LEE ETHERTON (NPI# 1912547365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1912547365
Entity Type Individual
Full Name THOMAS LEE ETHERTON
Credential NP-C
Practice Address 4425 Cole Ct Se
Olympia
WA 98501-4474
Practice Telephone 3608702011
Mailing Telephone 3608702011
Enumeration Date 2020-01-14
Last Update Date 2020-01-14
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP2300X Nurse Practitioner
Specialization: Primary Care
AP61034795 WA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 4425 COLE CT SE
City OLYMPIA
State WA
Zip Code 98501-4474

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Taxonomy Information

Taxonomy Code 363LP2300X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Primary Care

Taxonomy Definition

Definition to come...

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1962516377 Dianna L Kaiser Nurse Practitioner 3240 14th Ave Nw, Olympia, WA 98502-8509 2006-08-19

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Competitor

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City OLYMPIA
Zip Code 98501

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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