Thomas Benjamin Halvorson, LMP

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

License

MA60457447 Issued in WA

Practice address

5609 S Lawrence St
Tacoma, WA 98409-5319

Phone

(253) 380-2685

NPI assigned

Apr 15, 2014

Last updated

Apr 15, 2014By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1397520000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1397520000000",
    "number": "1710306022",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3933 S 302ND ST",
            "city": "AUBURN",
            "state": "WA",
            "postal_code": "980012225",
            "telephone_number": "253-380-2685"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5609 S LAWRENCE ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984095319",
            "telephone_number": "253-380-2685"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALVORSON",
        "first_name": "THOMAS",
        "middle_name": "BENJAMIN",
        "name_prefix": "Mr.",
        "credential": "LMP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2014-04-15",
        "last_updated": "2014-04-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "WA",
            "license": "MA60457447",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASINGTON STATE MASSAGE LICENCE",
            "identifier": "MA60457447",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Davonne Halseth, REGISTERED NURSE
• Tyra Marie Halverson, RD
• Delaney Halvorson
• Kirk Leigh Halvorson
• Logan McWhirter Halvorson
• Hey Jeong Ham, PHARM.D.
• Maren Michele Ham, BA
• Wendy F Hamai, PAC
• Michelle A Hambly
• Catherine Ross Hamel, SLPA

• Student in an Organized Health Care Education/Training Program in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Student in an Organized Health Care Education/Training Program in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 15, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.