Individual
JACQUELINE A THORESON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
2958 SE 27TH CT, GRESHAM, OR 97080-6293
(503) 667-1043
(503) 667-1043
Mailing address
2958 SE 27TH CT, GRESHAM, OR 97080-6293
(503) 667-1043
(503) 667-1043
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
—
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
098060
—
OR
Enumeration date
03/20/2007
Last updated
07/09/2007
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