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

Thomas Modad Soeprono, MD

Individual provider Psychiatry Physician · NPI 1245559467

Thomas Modad Soeprono, MD is a Psychiatry in Seattle, Washington. Graduated from Loma Linda University School of Medicine in 2010, 16 years ago. Practices with The Association of University Physicians, a 3,459-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Washington.

Years since qualifying
16
Trained at
Loma Linda University School of Medicine
Licensed in
WA
In the registry since
2010
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1959 NE Pacific St Box 356560
Seattle, WA 98195-0001
Phone: (206) 598-6195
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence MD60475121 (WA)

Record details

NPI number1245559467
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMay 27, 2010
Last updated in NPPESAugust 13, 2015

Medicare enrollment

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

Medicare specialtyPSYCHIATRY
Medical schoolLOMA LINDA UNIVERSITY SCHOOL OF MEDICINE
Graduated 2010 (16 years in practice)
Group practice The Association Of University Physicians — 3459 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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