Provider Demographics
NPI:1013400555
Name:THOMPSON, KIRSTEN (DO)
Entity Type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:123 S 27TH ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59101-4227
Mailing Address - Country:US
Mailing Address - Phone:406-247-3350
Mailing Address - Fax:406-247-3389
Practice Address - Street 1:3299 HILYARD ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-3721
Practice Address - Country:US
Practice Address - Phone:541-222-8620
Practice Address - Fax:541-222-8652
Is Sole Proprietor?:Yes
Enumeration Date:2018-06-10
Last Update Date:2023-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI510124010390200000X
390200000X
ORDO206396207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program