Provider Demographics
NPI:1851467021
Name:GERNE, THOMAS JOSEPH (DC)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:JOSEPH
Last Name:GERNE
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 1:1087 LEWIS RIVER RD # 239
Mailing Address - Street 2:
Mailing Address - City:WOODLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98674-9689
Mailing Address - Country:US
Mailing Address - Phone:360-225-8314
Mailing Address - Fax:360-225-6361
Practice Address - Street 1:1044 B ST
Practice Address - Street 2:
Practice Address - City:WOODLAND
Practice Address - State:WA
Practice Address - Zip Code:98674-9404
Practice Address - Country:US
Practice Address - Phone:360-225-8314
Practice Address - Fax:360-225-6361
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2018-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002674111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB07027Medicare PIN
WAU-80106Medicare UPIN