Provider Demographics
NPI:1184988180
Name:THOMAS FREEDLAND, DC
Entity type:Organization
Organization Name:THOMAS FREEDLAND, DC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:DALE
Authorized Official - Last Name:FREEDLAND
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:503-684-1273
Mailing Address - Street 1:9735 SW SHADY LN
Mailing Address - Street 2:SUITE 303
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-5481
Mailing Address - Country:US
Mailing Address - Phone:503-684-1273
Mailing Address - Fax:503-684-1274
Practice Address - Street 1:9735 SW SHADY LN
Practice Address - Street 2:SUITE 303
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-5481
Practice Address - Country:US
Practice Address - Phone:503-684-1273
Practice Address - Fax:503-684-1274
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-06-25
Last Update Date:2012-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2762111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty