Individual
DEREK MARK THOMPSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
1939 NE BROADWAY ST STE C, PORTLAND, OR 97232-1584
(503) 899-3695
Mailing address
14885 THAYER RD, OREGON CITY, OR 97045-9374
(503) 899-3695
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
LMT-26351
OR
Other
Enumeration date
07/09/2024
Last updated
07/09/2024
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