Individual
NATHAN THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3512 LONE PINE RD, MEDFORD, OR 97504-5637
(541) 772-1777
Mailing address
PO BOX 1121, ROSEBURG, OR 97470-0254
(541) 672-2691
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
03/21/2013
Last updated
10/23/2024
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