Elsemore, Thomas Stillman
Elsemore, Thomas Stillman is an sole proprietor health care provider with primary practice located at 1418 E Lakeshore Dr , Lake Stevens WA 98258-8638. He recently has only one registered license in Nursing Service Providers / Ophthalmic, which is considered as his primary health care specialty. Elsemore, Thomas Stillman can be contacted via phone (425) 334-8081.Contact Information
Primary practice address
1418 E Lakeshore Dr
Lake Stevens WA 98258-8638
Phone: (425) 334-8081
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Ophthalmic | 163WX1100X | RN00061277 | Washington |
Profile Details
| NPI number | 1407832983 |
|---|---|
| LBN Legal business name | Elsemore, Thomas Stillman |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 16th, 2005 |
| Last updated | Jan 5th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1407832983 | NPPES |
| Washington | MEDICAID | 9618489 | |
| Washington | Other | 202723 |
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