CARLY THOMPSON

Residential Treatment Facility, Emotionally Disturbed Children

Active Individual
NPI: 1710174404

Practice Address

722 NE 162ND AVE
Portland, OR 97230

Phone: (503) 255-4205

Specialties

Specialty Code Primary License
Residential Treatment Facility, Emotionally Disturbed Children 322D00000X Yes -

Frequently Asked Questions

NPI 1710174404 is the National Provider Identifier for CARLY THOMPSON, a Residential Treatment Facility, Emotionally Disturbed Children provider located in Portland, OR. This NPI was enumerated on September 26, 2007.
CARLY THOMPSON practices at 722 NE 162ND AVE, Portland, OR 97230.

Quick Facts

NPI
1710174404
Type
Individual
Enumerated
Sep 26, 2007
Last Updated
Sep 26, 2007

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