Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Thammasak Mingbunjerdsuk

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1720439490

Thammasak Mingbunjerdsuk is a Gastroenterology in Longview, Washington. Qualified in 2014, 12 years ago. Practices with Peacehealth, a 187-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
12
Licensed in
WA
In the registry since
2016
Specialties on file
2
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Practice location Address checks out

1615 Delaware St
Longview, WA 98632-2367
Phone: (360) 414-2000
Fax: (360) 414-7638
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 3601 4th St, Lubbock, TX 79430-0002 — (916) 436-6401

Specialties & licences

Gastroenterology Physician (primary) Taxonomy 207RG0100X · Licence MD61202611 (WA)
Student in an Organized Health Care Education/Training Program Taxonomy 390200000X

Record details

NPI number1720439490
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedJune 23, 2016
Last updated in NPPESApril 27, 2022
Certification dateApril 27, 2022
Mailing address223 Indiana Ave Apt 3211, Lubbock, TX 79415-5369

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyGASTROENTEROLOGY
Medical schoolOTHER
Graduated 2014 (12 years in practice)
Group practice Peacehealth — 187 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Longview