Individual
MS. MARY KATHRYN THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1130 NW 22ND AVE, SUITE 345, PORTLAND, OR 97210-2900
(503) 413-7513
(503) 413-7503
Mailing address
PO BOX 3808, PORTLAND, OR 97208-3808
(503) 413-5089
(503) 413-1860
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
200550127NP
OR
363LF0000X
Family Nurse Practitioner
000030387N1
OR
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
200550127NP
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
027956
—
OR
Enumeration date
02/17/2006
Last updated
12/12/2008
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