Provider Demographics
NPI:1497080576
Name:THOMPSON, BETHANY LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:BETHANY
Middle Name:LYNN
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:1800 VALLEY RIVER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-6714
Mailing Address - Country:US
Mailing Address - Phone:541-342-2201
Mailing Address - Fax:541-342-2245
Practice Address - Street 1:1800 VALLEY RIVER DR STE 100
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-6714
Practice Address - Country:US
Practice Address - Phone:541-342-2201
Practice Address - Fax:541-342-2245
Is Sole Proprietor?:No
Enumeration Date:2009-10-07
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3423ATI152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist