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Individual

DR. NATHANIEL B THOMAS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PSYD

Contact information

Practice address
2600 CENTER ST NE, SALEM, OR 97301-2669
(503) 947-8068
Mailing address
PO BOX 74, DALLAS, OR 97338-0074
(503) 947-8068

Taxonomy

Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
1018
OR
283Q00000X
Psychiatric Hospital
1018
OR

Other

Enumeration date
10/02/2012
Last updated
10/02/2012
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