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Individual
NATHANIEL SCOTT THORESON
Active
Individual
NATHANIEL SCOTT THORESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT1354
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010025022
REGENCE BLUE SHIELD
ID
01
—
126619
WASHINGTON L&I
WA
01
—
14490
GROUP HEALTH
ID
01
—
P00155553
RAILROAD MEDICARE
ID
01
—
T3548
BLUE CROSS
ID
Enumeration date
10/17/2006
Last updated
07/08/2007
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