Individual
MARY A THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
831 291ST AVE NE, CARNATION, WA 98014-9603
(425) 891-6680
Mailing address
831 291ST AVE NE, CARNATION, WA 98014
(425) 891-6680
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary
MA 60236187
WA
Other
Enumeration date
12/02/2011
Last updated
09/03/2019
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