Individual
MEGAN EMILY THYGESEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1200 NW 23RD AVE, PORTLAND, OR 97210-2906
(503) 413-7074
Mailing address
1200 NW 23RD AVE, PORTLAND, OR 97210-2906
(503) 413-7074
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD24260
OR
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
MD24260
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005900
—
OR
05
—
PENDING
—
OR
Enumeration date
05/12/2006
Last updated
05/21/2008
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