Individual
DR. MICHAEL P THILLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
117 NW LARCH AVE, REDMOND, OR 97756-1322
(541) 548-4014
(541) 548-0544
Mailing address
117 NW LARCH AVE, REDMOND, OR 97756-1322
(541) 548-4014
(541) 548-0544
Taxonomy
Speciality
Code
Description
License number
State
111NX0800X
Orthopedic Chiropractor
Primary
27-2309
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
058771001
BLUE CROSS
OR
01
—
122507
OMAP
OR
Enumeration date
11/13/2006
Last updated
07/09/2007
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