Provider Demographics
NPI:1184423766
Name:FLORES, TOMAS
Entity type:Individual
Prefix:MR
First Name:TOMAS
Middle Name:
Last Name:FLORES
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 928
Mailing Address - Street 2:
Mailing Address - City:MABTON
Mailing Address - State:WA
Mailing Address - Zip Code:98935-0928
Mailing Address - Country:US
Mailing Address - Phone:509-515-8361
Mailing Address - Fax:
Practice Address - Street 1:3908 1ST ST
Practice Address - Street 2:
Practice Address - City:UNION GAP
Practice Address - State:WA
Practice Address - Zip Code:98903-2004
Practice Address - Country:US
Practice Address - Phone:509-515-8361
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-07
Last Update Date:2025-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant