Individual
DR. GARY MARVIN THORNE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD, FACS
Contact information
Practice address
307 SAINT JOHNS WAY, SUITE 5, LEWISTON, ID 83501-2435
(208) 746-0133
(208) 746-0134
Mailing address
1624 SWALLOWS NEST LOOP, CLARKSTON, WA 99403-1726
(208) 758-0361
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M-3996
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010006068
REGENCE
ID
05
—
001529600
—
ID
01
—
0083005
DLI
ID
01
—
13DO521109
LAB
ID
05
—
1502103
—
WA
Enumeration date
08/21/2006
Last updated
07/09/2007
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