Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207U00000X | Nuclear Medicine Specialist | MD00008814 | WA |
NPI | 1396169892 |
---|---|
Provider Name | Dr. Thomas Daniel Mahony |
First Address | Richland, WA 99352 |
Second Address | Richland, WA 99352 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/02/2014 |
Last Update Date | 05/02/2014 |