Individual provider Active NPI

Thomas Howard Long, MD

  • Anatomic Pathology & Clinical Pathology Physician
  • Tukwila, WA
National Provider Identifier
1871933739
Registry record updated Aug 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X
License
MD6088832 Issued in WA
Practice address
12501 E Marginal Way S Ste 130
Tukwila, WA 98168-5163
Phone
(509) 892-2700
Fax
(509) 892-2740
NPI assigned
Jun 25, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dermatopathology (Pathology) Physician 207ZD0900X MD6088832 WA
Anatomic Pathology & Clinical Pathology Physician 207ZP0102X MD6088832 WA Primary

Addresses

Primary practice location

12501 E Marginal Way S Ste 130
Tukwila, WA 98168-5163

Mailing address

1959Nepacific St
Seattle, WA 98195-0001
Phone (541) 408-5216

Other practice location 1

3181 SW Sam Jackson Park Rd
Ohsu
Portland, OR 97239-3011
Phone (503) 494-8220

Other practice location 2

13103 E Mansfield Ave
Spokane Valley, WA 99216-1642
Phone (509) 892-2700

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230816001464 WA Practitioner - Pathology 2062729510 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare

Merit-based Incentive Payment System (MIPS)

Final score
73.29 of 100Reported as group
Quality
68.58
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD6088832WAMDAnatomic Pathology & Clinical Pathology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
The Vancouver Clinic Inc PS CurrentSince Aug 22, 2024 Accepting new patients
The Vancouver Clinic Inc PS CurrentSince Aug 22, 2024 Accepting new patients

Locations

3181 SW Sam Jackson Park Rd
Portland, OR 97239
Phone (503) 494-5674

12019 NE 99th St
Ste 1730
Vancouver, WA 98682

700 NE 87th Ave
Vancouver, WA 98664
Phone (360) 397-1500

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1372118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1724889600000",
    "number": "1871933739",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1959NEPACIFIC ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981950001",
            "telephone_number": "541-408-5216"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12501 E MARGINAL WAY S STE 130",
            "city": "TUKWILA",
            "state": "WA",
            "postal_code": "981685163",
            "telephone_number": "509-892-2700",
            "fax_number": "509-892-2740"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3181 SW Sam Jackson Park Rd",
            "address_2": "OHSU",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972393011",
            "country_code": "US",
            "telephone_number": "503-494-8220",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13103 E Mansfield Ave",
            "address_purpose": "LOCATION",
            "city": "Spokane Valley",
            "state": "WA",
            "postal_code": "992161642",
            "country_code": "US",
            "telephone_number": "509-892-2700",
            "fax_number": "509-892-2740",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LONG",
        "first_name": "THOMAS",
        "middle_name": "HOWARD",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-25",
        "last_updated": "2024-08-29",
        "certification_date": "2024-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZD0900X",
            "taxonomy_group": "",
            "desc": "Pathology, Dermatopathology",
            "state": "WA",
            "license": "MD6088832",
            "primary": false
        },
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "WA",
            "license": "MD6088832",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tukwila, WA

Sources for this page

Verify at the official NPI Registry.