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Individual

MR. THOMAS DAVID PRIMAVERA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OT

Contact information

Practice address
785 SE BAYSHORE DR, SUITE 102, OAK HARBOR, WA 98277-4062
(360) 279-8323
(360) 279-8772
Mailing address
785 SE BAYSHORE DR. SUITE 102, OAK HARBOR, WA 98277-4062
(360) 279-8323
(360) 279-8772

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
OT00000933
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0189569
DEPT OF LABOR & INDUSTRIE
WA
Enumeration date
03/07/2007
Last updated
02/17/2015
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