Active NPI
Thomas J Bourne, RN
- Pain Management Registered Nurse
- Everett, WA
National Provider Identifier
1811218266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pain Management Registered Nurse
- License
- 60125138
- Practice address
- 9617 7TH Ave SE
Everett, WA 98208-3710 - Phone
- (425) 513-8509
- NPI assigned
- Jun 21, 2010
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pain Management Registered Nurse | 163WP0000X | 60125138 | WA | Primary |
Addresses
Primary practice location
9617 7TH Ave SE
Everett, WA 98208-3710
Mailing address
15436 Bel Red Rd
Redmond, WA 98052-5536
Phone (425) 644-4100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 60125138 | WA | MD | Pain Management Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1277078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277078400000",
"number": "1811218266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "15436 BEL RED RD",
"city": "REDMOND",
"state": "WA",
"postal_code": "980525536",
"telephone_number": "425-644-4100"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9617 7TH AVE SE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982083710",
"telephone_number": "425-513-8509"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOURNE",
"first_name": "THOMAS",
"middle_name": "J",
"name_prefix": "Mr.",
"credential": "RN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-06-21",
"last_updated": "2010-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "163WP0000X",
"taxonomy_group": "",
"desc": "Registered Nurse, Pain Management",
"state": "WA",
"license": "60125138",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.