Basic Information
| Provider Information | |||||||||
| NPI: | 1265534028 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | BIRD | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | DWIGHT | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | UNIVERSITY OF WASHINGTON | ||||||||
| Address2: | BOX 356465 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981950001 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2065984030 | ||||||||
| FaxNumber: | 2067642569 | ||||||||
| Practice Location | |||||||||
| Address1: | 1660 S COLUMBIAN WAY | ||||||||
| Address2: | GRECC182 | ||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981081532 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2062774522 | ||||||||
| FaxNumber: | 2067642569 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2006 | ||||||||
| LastUpdateDate: | 09/14/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 204D00000X | MD00011262 | WA | Y | Allopathic & Osteopathic Physicians | Neuromusculoskeletal Medicine & OMM |
No ID Information.