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1558732966
JOHN WILLIAM THOMPSON
PORTLAND, OR
NPI
1558732966
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
320800000X Community Based Residential Treatment Facility, Mental Illness
(Licence: OR 320800000X)
Enumeration Date
2015-10-12
Last Update Date
2015-10-12
Business Address
-- JOHN WILLIAM THOMPSON
5538 NE 24TH AVE
PORTLAND, OR 97211-6206
Phone number: 503-757-0827
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Mailing Address
-- JOHN WILLIAM THOMPSON
5538 NE 24TH AVE
PORTLAND, OR 97211-6206
Phone number: 503-757-0827
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