Kali Marie Thibault, PHYSICIAN ASSISTANT
NPI #1336758432 in Lakewood, Washington
Provider Information
- NPI Number
- 1336758432
- Entity Type
- Individual
- Name
- Kali Marie Thibault, PHYSICIAN ASSISTANT
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PHYSICIAN ASSISTANT
- Enumeration Date
- Jul 24, 2020
- Last Updated
- Dec 18, 2020
Practice Location
- Address
- 11311 BRIDGEPORT WAY SW STE 309
- City
- Lakewood
- State
- Washington
- ZIP Code
- 98499-3078
- Phone
- (253) 985-2949
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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