Provider Demographics
NPI:1053603738
Name:THOMPSON, STEVEN N (B PHARM)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:N
Last Name:THOMPSON
Suffix:
Gender:M
Credentials:B PHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:930 MAKENA LN
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-7605
Mailing Address - Country:US
Mailing Address - Phone:541-399-4816
Mailing Address - Fax:
Practice Address - Street 1:520 MOUNT HOOD ST
Practice Address - Street 2:SAFEWAY PHARMACY 1489
Practice Address - City:THE DALLES
Practice Address - State:OR
Practice Address - Zip Code:97058-3555
Practice Address - Country:US
Practice Address - Phone:541-298-9634
Practice Address - Fax:541-298-9638
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2023-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00020598183500000X
ORRPJ-0010534183500000X
ORRPH-00105341835P0018X, 183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist