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Individual

MR. THOMAS TIMOTHY CAVANAUGH

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
C.R.N.A.

Contact information

Practice address
8540 DUNE LAKE RD SE, MOSES LAKE, WA 98837-8228
(509) 766-9043
Mailing address
8540 DUNE LAKE RD SE, MOSES LAKE, WA 98837-8228
(509) 766-9043

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
AP30004985
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
9605643
WA
Enumeration date
04/05/2006
Last updated
07/08/2007
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