Individual
MR. THOMAS LEE HALVORSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
820 MEMORIAL STREET, STE 3, PROSSER, WA 99350
(509) 786-5599
(509) 788-0488
Mailing address
723 MEMORIAL STREET, PROSSER, WA 99350
(509) 786-2222
(509) 786-6612
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
M12512
ID
207X00000X
Orthopaedic Surgery Physician
Primary
MD00037662
WA
207X00000X
Orthopaedic Surgery Physician
TLM-4023
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8244063
—
WA
Enumeration date
08/18/2005
Last updated
06/02/2021
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