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General NPI Number Information
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NPI Number | 1316178106
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Entity Type | Individual
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Provider Name | CHRISTOPHER LEE THOEN PMHNP
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Gender | Male
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Dates
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Enumeration Date | 07/28/2009
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Last Update Date | 07/28/2009
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Provider Practice Location Address
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Address Line | 8770 SW SCOFFINS ST
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City | TIGARD
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State | OR
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Zip | 97223-6226
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Country | US
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Telephone | 503-684-1424
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Fax | 503-684-1425
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Provider Business Mailing Address
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Address Line | PO BOX 82507
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City | PORTLAND
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State | OR
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Zip | 97282-0507
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WP0807X
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Taxonomy Name | Child & Adolescent Psychiatric/Mental Health Registered Nurse
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License Number | 200741788RN
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License Number State | OR
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 200950069NP
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License Number State | OR
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