Provider Demographics
NPI:1699726521
Name:WESTRAN, THOMAS ALAN (LMT)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:ALAN
Last Name:WESTRAN
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:269 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-4020
Mailing Address - Country:US
Mailing Address - Phone:503-693-3600
Mailing Address - Fax:503-846-9230
Practice Address - Street 1:269 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4020
Practice Address - Country:US
Practice Address - Phone:503-693-3600
Practice Address - Fax:503-846-9230
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR7283225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist