Provider Demographics
NPI:1013297480
Name:GAIL, THOMAS A
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:A
Last Name:GAIL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:707 N. HAYDEN ISLAND DR.
Mailing Address - Street 2:#405
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217
Mailing Address - Country:US
Mailing Address - Phone:503-283-8441
Mailing Address - Fax:503-283-8441
Practice Address - Street 1:707 N. HAYDEN ISLAND DR.
Practice Address - Street 2:#405
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97217
Practice Address - Country:US
Practice Address - Phone:503-283-8441
Practice Address - Fax:503-283-8441
Is Sole Proprietor?:Yes
Enumeration Date:2011-08-17
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR6380207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine