THOMAS MODAD SOEPRONO

SEATTLE, WA
NPI1245559467
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: WA  MD60475121)
Enumeration Date2010-05-27
Last Update Date2015-08-13
Business Address
-- THOMAS MODAD SOEPRONO M.D.
1959 NE PACIFIC ST BOX 356560
SEATTLE, WA 98195-0001
Phone number: 206-598-6195
Mailing Address
-- THOMAS MODAD SOEPRONO M.D.
PO BOX 50095
SEATTLE, WA 98145-5095
Phone number: 206-520-5700