Provider Demographics
NPI:1619742913
Name:MEADOWS, THOMAS (MS)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:
Last Name:MEADOWS
Suffix:
Gender:M
Credentials:MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 SE ETON LN
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97222-7429
Mailing Address - Country:US
Mailing Address - Phone:415-823-1193
Mailing Address - Fax:
Practice Address - Street 1:8050 SE 13TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-6694
Practice Address - Country:US
Practice Address - Phone:415-823-1193
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-16
Last Update Date:2023-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor