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1912004888
JACK ROBERT THOMAS
MOUNT VERNON, WA
NPI
1912004888
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
101YM0800X Counselor, Mental Health
(Licence: WA RC00036751)
Enumeration Date
2006-09-20
Last Update Date
2007-07-08
Business Address
-- JACK ROBERT THOMAS MA
1100 S 2ND ST
MOUNT VERNON, WA 98273-4209
Phone number: 364-193-5513
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Mailing Address
-- JACK ROBERT THOMAS MA
PO BOX 1307
LA CONNER, WA 98257-1307
Phone number: 360-466-0130
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