Provider Demographics
NPI:1497727127
Name:FLAMING, TOM L (DO)
Entity Type:Individual
Prefix:DR
First Name:TOM
Middle Name:L
Last Name:FLAMING
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 SE UGLOW AVE
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:OR
Mailing Address - Zip Code:97338-2645
Mailing Address - Country:US
Mailing Address - Phone:503-623-8376
Mailing Address - Fax:503-623-5293
Practice Address - Street 1:1000 SE UGLOW AVE
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:OR
Practice Address - Zip Code:97338-2645
Practice Address - Country:US
Practice Address - Phone:503-623-8376
Practice Address - Fax:503-623-5293
Is Sole Proprietor?:No
Enumeration Date:2006-02-06
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO10396207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR231084Medicaid
ORE03509Medicare UPIN
OR08WCGWZBMedicare ID - Type Unspecified