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Individual

THOMAS D DEA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA-C

Contact information

Practice address
5633 N LIDGERWOOD ST, SPOKANE, WA 99208-1224
(509) 482-2460
Mailing address
910 N WASHINGTON ST, SUITE 209, SPOKANE, WA 99201-2202
(509) 232-1173

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003775
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000010157088
REGENCE BS OF IDAHO
01
0210988
LABOR & INDUSTRIES
WA
01
6767DE
ASURIS NW HEALTH
WA
05
8417271
WA
01
P00418396
RAIL ROAD MEDICARE
Enumeration date
02/02/2006
Last updated
12/08/2007
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