MEDICARE: CLODAGH THOMPSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P1233	OTHER	AK	LICENSE#
2	6332	OTHER	OR	OREGON PT LICENSING BOARD

General Provider Information

NPI Number	:	1295809531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLODAGH THOMPSON

Provider Business Mailing Address
First Line	:	1232 UNIVERSITY OF OREGON
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97403-1205
Country	:	US
Telephone Number	:	541-346-4401
Fax Number	:

Provider Business Practice Location Address
First Line	:	1232 UNIVERSITY OF OREGON
Second Line	:
City	:	EUGENE
State	:	OR
Zip	:	97403-1205
Country	:	US
Telephone Number	:	541-346-4401
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/20/2006
Last Update Date	:	10/26/2012

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Directions to “ CLODAGH THOMPSON ” Practice Location

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