Individual
DWIGHT CHRISTIAN TAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 414-2000
Mailing address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 414-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61342488
WA
363A00000X
Physician Assistant
—
—
Other
Enumeration date
09/05/2022
Last updated
10/11/2022
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