Provider Demographics
NPI:1114060001
Name:TAHKEAL, ANTOINE (RT (R))
Entity Type:Individual
Prefix:
First Name:ANTOINE
Middle Name:
Last Name:TAHKEAL
Suffix:
Gender:M
Credentials:RT (R)
Other - Prefix:
Other - First Name:TONY
Other - Middle Name:
Other - Last Name:TAHKEAL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RT (R)
Mailing Address - Street 1:4210 HOLIDAY AVE
Mailing Address - Street 2:
Mailing Address - City:UNION GAP
Mailing Address - State:WA
Mailing Address - Zip Code:98903-2110
Mailing Address - Country:US
Mailing Address - Phone:509-225-6677
Mailing Address - Fax:
Practice Address - Street 1:401 BUSTER RD
Practice Address - Street 2:
Practice Address - City:TOPPENISH
Practice Address - State:WA
Practice Address - Zip Code:98948-9792
Practice Address - Country:US
Practice Address - Phone:509-865-2102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3198312471C3402X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3402XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistRadiography