Provider Demographics
NPI:1003041450
Name:AUKLAND, THOMAS GATES (LMT)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:GATES
Last Name:AUKLAND
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11911 SE DIVISION ST UNIT 20
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97266-1081
Mailing Address - Country:US
Mailing Address - Phone:503-761-4023
Mailing Address - Fax:503-761-4023
Practice Address - Street 1:11911 SE DIVISION ST UNIT 20
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-1081
Practice Address - Country:US
Practice Address - Phone:503-761-4023
Practice Address - Fax:503-761-4023
Is Sole Proprietor?:Yes
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60058033174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist