Provider Demographics
NPI:1063564185
Name:GILL, THOMAS ARTHUR (MSW)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:ARTHUR
Last Name:GILL
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8011 118TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-8031
Mailing Address - Country:US
Mailing Address - Phone:425-889-8524
Mailing Address - Fax:425-576-8274
Practice Address - Street 1:8011 118TH AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-8031
Practice Address - Country:US
Practice Address - Phone:425-889-8524
Practice Address - Fax:425-576-8274
Is Sole Proprietor?:No
Enumeration Date:2007-01-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000050151041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical