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Individual

GARY THOMAS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP

Contact information

Practice address
520 N 4TH AVE, PASCO, WA 99301-5257
(509) 547-7704
Mailing address
6528 W BARON DR, BOISE, ID 83714-6134
(971) 570-0683

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP61278332
WA
363LA2100X
Acute Care Nurse Practitioner
AP61278332
WA

Other

Enumeration date
03/25/2022
Last updated
12/29/2022
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