Individual
MISS AMY LARAINE THOMSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3900 PACIFIC AVE, FOREST GROVE, OR 97116-2226
(503) 359-0449
Mailing address
1240 NE 64TH LN UNIT 502, HILLSBORO, OR 97124-6619
(619) 519-0609
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
—
Other
Enumeration date
10/20/2011
Last updated
10/20/2011
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