Individual
GARY D THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPO/LPO
Contact information
Practice address
502 W NOB HILL BLVD UNIT 1, YAKIMA, WA 98902-5500
(509) 249-0011
(509) 249-0077
Mailing address
502 W NOB HILL BLVD UNIT 1, YAKIMA, WA 98902-5500
(509) 249-0011
(509) 249-0077
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PS00000366/OI0000038
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9058124
—
WA
Enumeration date
09/02/2006
Last updated
11/01/2007
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