Healthcare Provider Details

I. General information

NPI: 1306963368
Provider Name (Legal Business Name): PATRICIA A THOMAS R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/23/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2577 NE COURTNEY DR
BEND OR
97701-7638
US

IV. Provider business mailing address

1403 BARBERRY DR
TERREBONNE OR
97760-9617
US

V. Phone/Fax

Practice location:
  • Phone: 541-322-7400
  • Fax: 541-322-7618
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC1500X
TaxonomyCommunity Health Registered Nurse
License Number
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: