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Individual

DALLAS MITCHELL THORNTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CPHT

Contact information

Practice address
4818 POINT FOSDICK DR, GIG HARBOR, WA 98335-1711
(253) 851-6939
(253) 858-3203
Mailing address
1317 11TH LN # 288, FOX ISLAND, WA 98333-9661
(253) 549-2350

Taxonomy

Speciality
Code
Description
License number
State
374700000X
Technician
Primary
VA60898633
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
VA60898633
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
12/20/2022
Last updated
12/20/2022
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