Individual
MR. THOMAS EVERETTE IMIG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.D.P.
Contact information
Practice address
1030 NE COUCH ST., PORTLAND, OR 97232
(503) 239-8400
(503) 239-8407
Mailing address
1027 E. BURNSIDE ST., PORTLAND, OR 97214
(503) 239-8400
(503) 269-8407
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
00004925
WA
Other
Enumeration date
03/17/2015
Last updated
03/17/2015
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