Provider Demographics
NPI:1073571246
Name:J KIM THIRINGER DO PC
Entity Type:Organization
Organization Name:J KIM THIRINGER DO PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:J
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:THIRINGER
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:503-648-8971
Mailing Address - Street 1:1275 NW BENFIELD DR
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97229-4127
Mailing Address - Country:US
Mailing Address - Phone:503-648-8971
Mailing Address - Fax:
Practice Address - Street 1:900 SE OAK ST
Practice Address - Street 2:SUITE 201
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97123-4253
Practice Address - Country:US
Practice Address - Phone:503-648-8971
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORDO26348207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty