Provider Demographics
NPI:1487821088
Name:THOMAS, ASIA ANTOINETTE (RN)
Entity Type:Individual
Prefix:
First Name:ASIA
Middle Name:ANTOINETTE
Last Name:THOMAS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ASIA
Other - Middle Name:
Other - Last Name:CHEEKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LVN
Mailing Address - Street 1:322 S BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:MCCLEARY
Mailing Address - State:WA
Mailing Address - Zip Code:98557-9522
Mailing Address - Country:US
Mailing Address - Phone:360-205-4750
Mailing Address - Fax:360-839-2815
Practice Address - Street 1:322 S BIRCH ST
Practice Address - Street 2:
Practice Address - City:MCCLEARY
Practice Address - State:WA
Practice Address - Zip Code:98557-9522
Practice Address - Country:US
Practice Address - Phone:360-205-4750
Practice Address - Fax:360-839-2815
Is Sole Proprietor?:No
Enumeration Date:2008-05-13
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA231423164X00000X
WAN261446451163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No164X00000XNursing Service ProvidersLicensed Vocational Nurse