Provider Demographics
NPI:1568502193
Name:HARLAN, THOMAS L (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:L
Last Name:HARLAN
Suffix:
Gender:M
Credentials:DC
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 802
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-0802
Mailing Address - Country:US
Mailing Address - Phone:360-779-4900
Mailing Address - Fax:360-779-4900
Practice Address - Street 1:17791 FJORD DR NE
Practice Address - Street 2:#212
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-8481
Practice Address - Country:US
Practice Address - Phone:360-779-4900
Practice Address - Fax:360-779-4900
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1443111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor