Individual
ELIZA THOMPSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15700 SW GREYSTONE CT, BEAVERTON, OR 97006-6011
(503) 494-9001
(503) 494-1133
Mailing address
15700 SW GREYSTONE CT, BEAVERTON, OR 97006-6011
(503) 494-9001
(503) 494-1133
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
AP61084248
WA
207Q00000X
Family Medicine Physician
RN61084245
WA
363LF0000X
Family Nurse Practitioner
Primary
10005305
OR
363LF0000X
Family Nurse Practitioner
202002277RN
OR
363LF0000X
Family Nurse Practitioner
390200000X
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
390200000X
YAKIMA CLINIC
—
Enumeration date
08/11/2020
Last updated
04/13/2023
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