Basic Information
Provider Information
NPI: 1447997085
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: THOMAS
FirstName: JOSEPH
MiddleName: HEMMARD
NamePrefix:  
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1001 S MILDRED ST APT 203
Address2:  
City: TACOMA
State: WA
PostalCode: 984651803
CountryCode: US
TelephoneNumber: 6784780557
FaxNumber:  
Practice Location
Address1: 1305 TACOMA AVE S STE 201
Address2:  
City: TACOMA
State: WA
PostalCode: 984021903
CountryCode: US
TelephoneNumber: 2533965823
FaxNumber:  
Other Information
ProviderEnumerationDate: 05/16/2022
LastUpdateDate: 05/16/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 05/16/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101Y00000X  Y Behavioral Health & Social Service ProvidersCounselor 

No ID Information.


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