Thomas, Timothy Charles

Thomas, Timothy Charles is an individual health care provider with primary practice located at 1022 W Ivy Ave , Moses Lake WA 98837-4107. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Thomas, Timothy Charles can be contacted via phone (509) 765-7845.

Contact Information

Primary practice address
1022 W Ivy Ave Moses Lake WA 98837-4107
Phone: (509) 765-7845
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X OD3994 Washington

Profile Details

NPI number 1548250905
LBN Legal business name Thomas, Timothy Charles
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2005
Last updated Dec 21st, 2007 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548250905 NPPES
Washington MEDICAID 2030955

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