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General NPI Number Information
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NPI Number | 1497675185
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Entity Type | Organization
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Legal Business Name | THOMPSON MAINSTAY II LLC
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Dates
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Enumeration Date | 07/21/2026
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Last Update Date | 07/21/2026
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Provider Practice Location Address
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Address Line | 1585 SW MARLOW AVE STE 100
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City | PORTLAND
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State | OR
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Zip | 97225-5177
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Country | US
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Telephone | 503-297-1717
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Fax |
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Provider Business Mailing Address
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Address Line | 1951 OAK ST STE A
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City | FOREST GROVE
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State | OR
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Zip | 97116-2005
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Country | US
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Telephone | 503-357-9122
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JARED M THOMPSON
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Credential | DMD
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Telephone | 503-351-9043
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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