Individual
MR. THOMAS MARVIN VINCENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
4815 N ASSEMBLY ST, SPOKANE, WA 99205-6185
(509) 434-7010
(509) 434-7131
Mailing address
4815 N ASSEMBLY ST, SPOKANE, WA 99205-6185
(509) 434-7010
(509) 434-7131
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10003468
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1019968
NCCPA CERTIFICATE #
WA
05
—
805491500
—
WA
Enumeration date
06/30/2006
Last updated
10/13/2016
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