Provider Demographics
NPI:1659125029
Name:THOMSON, ASPEN NICOLE
Entity Type:Individual
Prefix:MS
First Name:ASPEN
Middle Name:NICOLE
Last Name:THOMSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3532 SW BEAVERTON HILLSDALE HWY
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97221-3810
Mailing Address - Country:US
Mailing Address - Phone:208-596-7663
Mailing Address - Fax:
Practice Address - Street 1:2236 SE BELMONT ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-2817
Practice Address - Country:US
Practice Address - Phone:503-445-7699
Practice Address - Fax:503-802-0199
Is Sole Proprietor?:No
Enumeration Date:2024-04-12
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health