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Individual

THOMAS R PALMER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
6108 NE GLISAN ST, PORTLAND, OR 97213-3864
(503) 255-8100
(503) 255-2728
Mailing address
6108 NE GLISAN ST, PORTLAND, OR 97213-3864
(503) 255-8100
(503) 255-2728

Taxonomy

Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
DP00202
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
137490
MEDICARE GROUP #
OR
05
170446
OR
Enumeration date
06/13/2006
Last updated
02/02/2009
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