Individual
MRS. CAROLINE KEZIAH THIONGO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
12360 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-9320
(503) 303-4000
(503) 344-4412
Mailing address
21155 E DUNCAN ST, QUEEN CREEK, AZ 85142-6763
(972) 302-1431
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
298740
AZ
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
10021621
OR
Other
Enumeration date
11/21/2023
Last updated
08/19/2024
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