Thompson, Mary Kathryn

Thompson, Mary Kathryn is an individual health care provider with primary practice located at 1130 Nw 22Nd Ave Suite 345, Portland OR 97210-2900. She recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Family, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Thompson, Mary Kathryn can be contacted via phone (503) 413-7513.

Contact Information

Primary practice address
1130 Nw 22Nd Ave Suite 345 Portland OR 97210-2900
Phone: (503) 413-7513
Fax: (503) 413-7503
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 000030387N1 Oregon
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X 200550127NP Oregon
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 200550127NP Oregon

Profile Details

NPI number 1104891779
LBN Legal business name Thompson, Mary Kathryn
Credentials PMHNP
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 17th, 2006
Last updated Dec 12th, 2008 - about 16 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1104891779 NPPES
Oregon MEDICAID 027956

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