Provider Demographics
NPI:1588606511
Name:THOMPSON, GRETCHEN LEE (RN)
Entity Type:Individual
Prefix:MS
First Name:GRETCHEN
Middle Name:LEE
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3072 GREENBROOK CT NE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97305-2922
Mailing Address - Country:US
Mailing Address - Phone:503-945-6484
Mailing Address - Fax:
Practice Address - Street 1:3072 GREENBROOK CT NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97305-2922
Practice Address - Country:US
Practice Address - Phone:503-945-6484
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health