Provider Demographics
NPI:1447364799
Name:THAMERT, CAROL JEAN (MN ARNP FNPC NCBC)
Entity type:Individual
Prefix:MS
First Name:CAROL
Middle Name:JEAN
Last Name:THAMERT
Suffix:
Gender:F
Credentials:MN ARNP FNPC NCBC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:10824 SE OAK ST # 333
Mailing Address - Street 2:
Mailing Address - City:MILWAUKIE
Mailing Address - State:OR
Mailing Address - Zip Code:97222-6694
Mailing Address - Country:US
Mailing Address - Phone:503-902-4756
Mailing Address - Fax:
Practice Address - Street 1:10435 SE COOK CT
Practice Address - Street 2:APT 380
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97222
Practice Address - Country:US
Practice Address - Phone:503-902-4756
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30007371363LF0000X
OR201393030NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily