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Individual

MR. PAUL NORMAN THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
11790 SW BARNES RD BLDG A, SUITE 140, PORTLAND, OR 97225-5934
(503) 643-2100
(503) 643-7300
Mailing address
11790 SW BARNES RD BLDG A, SUITE 140, PORTLAND, OR 97225-5934
(503) 643-2100
(503) 643-7300

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD15689
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
021993005
BLUE CROSS
OR
05
054499
OR
01
301242
PROVIDENCE HEALTH PLAN
OR
01
93112982997006A004
TRI WEST
Enumeration date
05/02/2006
Last updated
06/13/2008
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