Healthcare Provider Details

I. General information

NPI: 1568437473
Provider Name (Legal Business Name): THOMAS LOUIS TORRES RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 02/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26015 104TH AVE SE
KENT WA
98030-7647
US

IV. Provider business mailing address

24520 128TH AVE E
GRAHAM WA
98338-8950
US

V. Phone/Fax

Practice location:
  • Phone: 253-850-6480
  • Fax: 253-850-6498
Mailing address:
  • Phone: 206-799-6181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00016901
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: