Individual
MR. THEODORE ROHAN THOMAS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 414-2000
Mailing address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 414-2000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61012347
WA
Other
Enumeration date
08/28/2018
Last updated
02/11/2023
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