Provider Demographics
NPI:1235353996
Name:THOMAS, KRISTEN LEIGH (MD)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:LEIGH
Last Name:THOMAS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 N GRAHAM ST
Mailing Address - Street 2:SUITE 200
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97227-2000
Mailing Address - Country:US
Mailing Address - Phone:503-413-4488
Mailing Address - Fax:503-413-1812
Practice Address - Street 1:501 N GRAHAM ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97227-2000
Practice Address - Country:US
Practice Address - Phone:503-413-4488
Practice Address - Fax:503-413-1813
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY252969207X00000X
OR164327207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery