Provider Demographics
NPI:1215153630
Name:MCGRATH, THOMAS GENTRY (DC, DACNB)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:GENTRY
Last Name:MCGRATH
Suffix:
Gender:M
Credentials:DC, DACNB
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14405 NE 20TH ST
Mailing Address - Street 2:SUITE 1
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-3710
Mailing Address - Country:US
Mailing Address - Phone:425-641-2527
Mailing Address - Fax:425-641-5337
Practice Address - Street 1:14405 NE 20TH ST
Practice Address - Street 2:SUITE 1
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98007-3710
Practice Address - Country:US
Practice Address - Phone:425-641-2527
Practice Address - Fax:425-641-5337
Is Sole Proprietor?:No
Enumeration Date:2007-04-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00003532111NN0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NN0400XChiropractic ProvidersChiropractorNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAGAB04013Medicare ID - Type Unspecified