Thomas Alexander Poore

Primary specialty

PodiatristTaxonomy code 213E00000X

License

DP202571 Issued in OR

Practice address

9370 SW Greenburg Rd Ste 102
Portland, OR 97223-5428

Phone

(503) 244-7894

Fax

(503) 244-7814

NPI assigned

Apr 4, 2017

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1491264000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622678400000",
    "number": "1871026286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16701 SE MCGILLIVRAY BLVD STE 220",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986833462",
            "telephone_number": "360-834-3707",
            "fax_number": "360-834-3569"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9370 SW GREENBURG RD STE 102",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972235428",
            "telephone_number": "503-244-7894",
            "fax_number": "503-244-7814"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6108 NE Highway 99 Ste 107",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986658751",
            "country_code": "US",
            "telephone_number": "360-597-4223",
            "fax_number": "360-597-4275",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1710 W Main St Ste 221",
            "address_purpose": "LOCATION",
            "city": "Battle Ground",
            "state": "WA",
            "postal_code": "986044317",
            "country_code": "US",
            "telephone_number": "360-687-3668",
            "fax_number": "360-687-3670",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "16701 SE McGillivray Blvd Ste 220",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986833462",
            "country_code": "US",
            "telephone_number": "360-834-3707",
            "fax_number": "360-834-3569",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "POORE",
        "first_name": "THOMAS",
        "middle_name": "ALEXANDER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-04-04",
        "last_updated": "2021-06-03",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "WA",
            "license": "PO61122479",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "213E00000X",
            "taxonomy_group": "",
            "desc": "Podiatrist",
            "state": "OR",
            "license": "DP202571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2177764",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500788080",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Leslie Poole
• Maxwell Charles Poole
• Robin Rose Pooley
• Thanissara Poomlaochaeng
• Wesley F Poon, D.C
• Jay C Poorman, M.D.
• Antony Mathew Poothullil, MD
• Andrew Pop
• Angela S Pope Gorrow, LMT
• Moira Teletha Pope-Reid

• Podiatrist in Portland, OR
• Providers in Portland, OR by specialty
• Podiatrist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.