Basic Information
| Provider Information | |||||||||
| NPI: | 1457765232 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | SCHLEICHERT | ||||||||
| FirstName: | THOMAS | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11311 BRIDGEPORT WAY SW | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984993071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2539852733 | ||||||||
| FaxNumber: | 2539852868 | ||||||||
| Practice Location | |||||||||
| Address1: | 11311 BRIDGEPORT WAY SW | ||||||||
| Address2: | |||||||||
| City: | LAKEWOOD | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984993071 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2539852733 | ||||||||
| FaxNumber: | 2539852868 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2014 | ||||||||
| LastUpdateDate: | 12/09/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/09/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 5101021096 | MI | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | OP60950081 | WA | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 2139658 | 05 | WA | MEDICAID |