Individual
AMY A THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHP-C
Contact information
Practice address
1310 SW 17TH AVE, PORTLAND, OR 97201-2522
(503) 231-2641
(503) 467-4077
Mailing address
211 SE CARUTHERS ST, PORTLAND, OR 97214-4502
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
19-QMHPC-00740
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500774161
—
OR
Enumeration date
09/29/2009
Last updated
01/23/2025
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