Individual
DR. TIMOTHY CHARLES THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
1022 W IVY AVE, MOSES LAKE, WA 98837-4107
(509) 765-7845
Mailing address
1022 W IVY AVE, MOSES LAKE, WA 98837-4107
(509) 765-7845
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD3994
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2030955
—
WA
Enumeration date
10/26/2005
Last updated
12/21/2007
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