Individual
BRIAN MICHAEL THATCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
LIFEWORKS NORTHWEST, 5415 SW WESTGATE DRIVE, PORTLAND, OR 97221
(503) 645-3581
Mailing address
LIFEWORKS NORTHWEST, 14600 NW CORNELL ROAD, PORTLAND, OR 97229-5442
(503) 645-3581
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
T-21-612
OR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
01/15/2021
Last updated
06/24/2021
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