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Individual

DR. MICAH LAURENCE THORP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
6902 SE LAKE RD, MILWAUKIE, OR 97267-2148
(503) 232-4465
Mailing address
6902 SE LAKE RD, MILWAUKIE, OR 97267-2148
(503) 232-4465

Taxonomy

Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
DO20155
OR
207RN0300X
Nephrology Physician
OP00001659
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
288472
OR
Enumeration date
08/16/2006
Last updated
08/23/2022
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