Provider Demographics
NPI:1982818274
Name:GILMORE, THOMAS C (OD)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:C
Last Name:GILMORE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2229 MARINER BEACH DR
Mailing Address - Street 2:
Mailing Address - City:OAK HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98277-8600
Mailing Address - Country:US
Mailing Address - Phone:360-679-4261
Mailing Address - Fax:
Practice Address - Street 1:1211 S 40TH AVE
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-3961
Practice Address - Country:US
Practice Address - Phone:509-966-2966
Practice Address - Fax:509-966-3230
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD00000678152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist