Provider Demographics
NPI:1992905954
Name:CATON, TOM DONOVAN (LMP)
Entity type:Individual
Prefix:MR
First Name:TOM
Middle Name:DONOVAN
Last Name:CATON
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:78 S MARKET BLVD
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:CHEHALIS
Mailing Address - State:WA
Mailing Address - Zip Code:98532-3036
Mailing Address - Country:US
Mailing Address - Phone:360-520-9898
Mailing Address - Fax:360-978-5716
Practice Address - Street 1:78 S MARKET BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:CHEHALIS
Practice Address - State:WA
Practice Address - Zip Code:98532-3036
Practice Address - Country:US
Practice Address - Phone:360-520-9898
Practice Address - Fax:360-978-5716
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022411172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA00022411OtherWA STATE MASSAGE LICENSE