Individual
CHRISTINA LEILA THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1111 NE 99TH AVE, PORTLAND, OR 97220-9428
(503) 963-2707
(503) 963-2802
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
015985-1
NY
363AM0700X
Medical Physician Assistant
Primary
PA174608
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2049303
—
WA
05
—
500694968
—
OR
Enumeration date
09/27/2012
Last updated
11/04/2024
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