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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1407832983 NPPES
Washington MEDICAID 9618489
Washington Other 202723

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