Whalio Doctors

NPI 1407527369

Thomas Kowalski, IDHS

Practitioner Independent Duty Corpsman Portland, OR

Practice location

Address
6767 N Basin Ave, Portland, OR 97217-3929
Phone
(503) 240-9343
Mailing address
11408 NE 128th Pl, Vancouver, WA 98682-1784

Registered specialties

Independent Duty Corpsman Primary
Other Service Providers Taxonomy 1710I1002X

Registry record

NPI
1407527369
Entity type
Individual
Sex (as registered)
Male
NPI issued
21 Sep 2021
Record last updated
18 Oct 2021

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.