Healthcare Provider Details

I. General information

NPI: 1851929806
Provider Name (Legal Business Name): LOREE BETH THORNTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LOREE BETH SMITH

II. Dates (important events)

Enumeration Date: 03/27/2020
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2211 NE 139TH ST
VANCOUVER WA
98686-2742
US

IV. Provider business mailing address

2525 NE 139TH ST STE 260
VANCOUVER WA
98686-2719
US

V. Phone/Fax

Practice location:
  • Phone: 303-210-9980
  • Fax:
Mailing address:
  • Phone: 303-210-9980
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License NumberMD.MD.70125510
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number43597
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: