Healthcare Provider Details

I. General information

NPI: 1326002601
Provider Name (Legal Business Name): THELMA J MAYS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/14/2006
Last Update Date: 01/31/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11782 SW BARNES RD BLDG C 200
PORTLAND OR
97225
US

IV. Provider business mailing address

5319 SW WESTGATE DR 241
PORTLAND OR
97221-2432
US

V. Phone/Fax

Practice location:
  • Phone: 503-906-4300
  • Fax: 503-906-4333
Mailing address:
  • Phone: 503-297-7223
  • Fax: 503-297-7603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD17458
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: