Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086S0122X | Plastic and Reconstructive Surgery | MD00017483 | WA |
NPI | 1265744585 |
---|---|
Provider Name | Dr. Thomas D Gant |
First Address | Tonasket, WA 98855-8803 |
Second Address | Kirkland, WA 98034-6115 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/07/2010 |
Last Update Date | 10/01/2020 |