Individual
WHITNEY THOMAS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12710 SE DIVISION ST, PORTLAND, OR 97236-3134
(503) 988-5558
Mailing address
12710 SE DIVISION ST, PORTLAND, OR 97236-3134
(503) 988-5558
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
202113520NP-PP
OR
363LF0000X
Family Nurse Practitioner
AP61241993
WA
Other
Enumeration date
03/08/2022
Last updated
03/16/2024
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