Provider Demographics
NPI:1477522795
Name:CRAWFORD, THOMAS I II (MD)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:I
Last Name:CRAWFORD
Suffix:II
Gender:M
Credentials:MD
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 22009
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97269-2009
Mailing Address - Country:US
Mailing Address - Phone:503-558-7372
Mailing Address - Fax:503-344-5140
Practice Address - Street 1:5050 NE HOYT ST
Practice Address - Street 2:SUITE 445
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97213-2991
Practice Address - Country:US
Practice Address - Phone:503-231-0166
Practice Address - Fax:503-231-2720
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2022-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD13876207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR27152-8Medicaid
OR27152-8Medicaid
ORC92451Medicare UPIN
OR00WCTBYBMedicare PIN