Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD00026931 | WA |
Y | 2086S0105X | Surgery of the Hand | MD00026931 | WA |
NPI | 1184640161 |
---|---|
Provider Name | Eric Thorson |
First Address | Wenatchee, WA 98801-2028 |
Second Address | Wenatchee, WA 98801-2028 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/07/2006 |
Last Update Date | 21/03/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1184640161 | (05) | WA |
56417 | L&I (01) | WA |
A52441 | (02) | WA |
P01256402 | RR MEDICARE (01) | WA |