Healthcare Provider Details

I. General information

NPI: 1821125568
Provider Name (Legal Business Name): THOMAS MACLAY III PT, MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1733 H ST STE 400
BLAINE WA
98230-5107
US

IV. Provider business mailing address

8862 BENDER RD STE 101
LYNDEN WA
98264-8800
US

V. Phone/Fax

Practice location:
  • Phone: 360-332-5111
  • Fax: 360-332-3444
Mailing address:
  • Phone: 360-332-5111
  • Fax: 360-332-3444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number0274541
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number5555
License Number StateOR
# 3
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number040.0087580
License Number StateVT
# 4
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT.PT.70083240
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: