Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225CA2400X | Assistive Technology Practitioner | ||
Y | 225CX0006X | Orientation and Mobility Training Provider |
NPI | 1659727758 |
---|---|
Provider Name | Mr. Paul Thomas |
First Address | Vancouver, WA 98661-3713 |
Second Address | Vancouver, WA 98661-3713 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 06/05/2016 |
Last Update Date | 06/05/2016 |