Individual
ISAAC ANIHILI THELIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PMHNP-BC
Contact information
Practice address
700 NE MULTNOMAH ST STE 275, PORTLAND, OR 97232-4103
(503) 729-1380
Mailing address
3331 NE 61ST AVE, PORTLAND, OR 97213-3933
(503) 896-7112
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
202009552NP-PP
OR
Other
Enumeration date
10/20/2020
Last updated
10/20/2020
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