Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RP1001X | Pulmonary Disease | MD60383918 | WA |
NPI | 1043535370 |
---|---|
Provider Name | Thomas Warren Decato |
First Address | Liberty Lake, WA 99019-0421 |
Second Address | Spokane, WA 99208 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2010 |
Last Update Date | 24/05/2021 |