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1710306022
THOMAS BENJAMIN HALVORSON
TACOMA, WA
NPI
1710306022
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
(Licence: WA ma60457447)
Enumeration Date
2014-04-15
Last Update Date
2014-04-15
Business Address
Mr. THOMAS BENJAMIN HALVORSON LMP
5609 S LAWRENCE ST
TACOMA, WA 98409-5319
Phone number: 253-380-2685
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Mailing Address
Mr. THOMAS BENJAMIN HALVORSON LMP
3933 S 302ND ST
AUBURN, WA 98001-2225
Phone number: 253-380-2685
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