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General NPI Number Information
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NPI Number | 1770703498
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Entity Type | Individual
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Provider Name | THOMAS GEORGE GARDNER P.T., D.P.T., A.T.C.
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Gender | Male
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Dates
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Enumeration Date | 04/26/2007
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Last Update Date | 05/26/2009
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Provider Practice Location Address
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Address Line | 1551 NW 54TH ST
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City | SEATTLE
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State | WA
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Zip | 98107-3845
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Country | US
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Telephone | 206-368-6100
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Fax |
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Provider Business Mailing Address
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Address Line | 608 N 47TH ST
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City | SEATTLE
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State | WA
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Zip | 98103-6450
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Country | US
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Telephone | 609-947-0457
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 7655
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 1926
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License Number State | AK
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Taxonomy #3
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 18245
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License Number State | MA
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Taxonomy #4
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 60083661
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License Number State | WA
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