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Individual
THAD GIBLETTE
Active
Individual
THAD GIBLETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
59480
ID
363L00000X
Nurse Practitioner
AP60910202
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699819292
—
ID
05
—
1699819292
—
WA
Enumeration date
02/16/2007
Last updated
12/05/2018
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