Phuong Thai Thach, NMD, AP, DIPL. O.M.
Individual provider Active NPI Naturopath · Pensacola, FL
NPI 1689225930 · NPPES record last updated Aug 25, 2026
Key facts
- NPI
- 1689225930
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Naturopath 175F00000X
- License
- NT60999770 (WA)
- Practice address
- 12855 Lillian Hwy
Pensacola, FL 32506-8422 - Phone
- (850) 304-7881
- NPI assigned
- Sep 26, 2019
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4359 | FL | MD | Acupuncturist |
| NT60999770 | WA | MD | Naturopath |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Acupuncturist |
171100000X | WA | ||
| Naturopath |
175F00000X | WA | ||
| Naturopath | 175F00000X | NT60999770 | WA | Yes |
| Acupuncturist | 171100000X | 4359 | FL |
Addresses
Primary practice location
12855 Lillian Hwy
Pensacola, FL 32506-8422
Mailing address
12855 Lillian Hwy
Pensacola, FL 32506-8422
Phone (850) 304-7881
Other providers in Pensacola, FL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 25, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.