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Individual

MS. MYRA L THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
F.N.P.

Contact information

Practice address
38505 BROOTEN RD, SUITE A, PACIFIC CITY, OR 97135
(541) 994-6523
Mailing address
38505 BROOTEN RD, SUITE A, PACIFIC CITY, OR 97135
(541) 994-6523

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
083030466N1
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
129788
OR
Enumeration date
02/20/2007
Last updated
03/25/2008
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