Individual
MR. THEODORE PHILLIP CHASE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP
Contact information
Practice address
2500 WESTGATE, PENDLETON, OR 97801-9606
(541) 278-7128
Mailing address
1902 SW 45TH ST, PENDLETON, OR 97801-4251
(541) 276-9680
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
OR
Other
Enumeration date
05/16/2007
Last updated
07/08/2007
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