| Doctor Name: | JOLYNN MARIE THOMPSON |
| NPI Number: | 1013252337 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PSS |
| License Number: | 171M0000X |
| Business Practice Address: | 421 Sw Oak St Portland, OR - 972041817 |
| Business Phone Number: | 5039885464 |
| Business Fax Number: | 5039885870 |
| Mailing Address: | 421 Sw Oak St, PORTLAND |
| State: | OR |
| Postal Code: | 972041817 |
| Phone Number: | 5039885464 |
| Fax Number: | 5039885870 |
| NPI Enumeration Date: | 11/28/2012 |
| NPI Last Update Date: | 11/28/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 302R00000X |
| License Number: | 171M0000X |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | OR |
| Taxonomy Type: | Managed Care Organizations |
| Taxonomy Classification: | Health Maintenance Organization |
| Taxonomy Specialization: | |
| Taxonomy Definition: | (1) A form of health insurance in which its members prepay a premium for the HMO |