Healthcare Provider Details

I. General information

NPI: 1073571246
Provider Name (Legal Business Name): J KIM THIRINGER DO PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 SE OAK ST SUITE 201
HILLSBORO OR
97123-4253
US

IV. Provider business mailing address

1275 NW BENFIELD DR
PORTLAND OR
97229-4127
US

V. Phone/Fax

Practice location:
  • Phone: 503-648-8971
  • Fax:
Mailing address:
  • Phone: 503-648-8971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License NumberDO26348
License Number StateOR

VIII. Authorized Official

Name: J KIM THIRINGER
Title or Position: DIRECTOR
Credential: D.O.
Phone: 503-648-8971