Individual
CASEY E THOMAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4745 HORSESHOE CT SE, SALEM, OR 97317-5539
(971) 304-8708
Mailing address
4745 HORSESHOE CT SE, SALEM, OR 97317-5539
(971) 304-8708
Taxonomy
Speciality
Code
Description
License number
State
3747A0650X
Attendant Care Provider
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3747A0650X
DEPARTMENT OF VETERIAN AFFAIRS PAYMENT CENTER
OR
Enumeration date
09/09/2019
Last updated
09/09/2019
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