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Individual

DR. JANE KUCERA THOMPSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PHD

Contact information

Practice address
1015 S 40TH AVE SUITE 24, EAST SLOPE NEUROPSYCHOLOGY INC, YAKIMA, WA 98908-3868
(509) 966-2961
(509) 966-2318
Mailing address
1015 S 40TH AVE, SUITE 24, YAKIMA, WA 98908-3868
(509) 966-2961
(509) 966-2318

Taxonomy

Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
PY2939
WA
103T00000X
Psychologist
PY2939
WA
103TC0700X
Clinical Psychologist
PY00002939
WA
103TR0400X
Rehabilitation Psychologist
PY00002939
WA
103TR0400X
Rehabilitation Psychologist

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
200926665
FED ID
WA
Enumeration date
11/17/2006
Last updated
01/04/2018
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