Provider Demographics
NPI:1245714070
Name:THAI, AUBREY ANN (RN)
Entity type:Individual
Prefix:
First Name:AUBREY
Middle Name:ANN
Last Name:THAI
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:AUBREY
Other - Middle Name:ANN
Other - Last Name:CRONK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:557 SW 197TH PL
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-2473
Mailing Address - Country:US
Mailing Address - Phone:360-924-1664
Mailing Address - Fax:
Practice Address - Street 1:3710 SW US VETERANS HOSPITAL RD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-2964
Practice Address - Country:US
Practice Address - Phone:360-924-1664
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-18
Last Update Date:2018-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201804527RN163WM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical