Individual
THOMAS J BYRNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
109 E HARRISON AVE, COEUR D ALENE, ID 83814-3238
(208) 292-0281
(844) 807-3877
Mailing address
PO BOX 1387, HAYDEN, ID 83835-1387
(208) 415-0299
(208) 625-2070
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA10004704
WA
363A00000X
Physician Assistant
Primary
PA167
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1030537
NCCPA
ID
05
—
8406456
—
WA
01
—
P00216067
RAILROAD MCR
—
Enumeration date
12/08/2006
Last updated
09/01/2021
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