Provider Demographics
NPI:1609243963
Name:THOMPSON, KRISTINA LOHR (PT)
Entity type:Individual
Prefix:
First Name:KRISTINA
Middle Name:LOHR
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:KRISTINA
Other - Middle Name:DENISE
Other - Last Name:LOHR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PT
Mailing Address - Street 1:5200 SW MACADAM AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-3843
Mailing Address - Country:US
Mailing Address - Phone:503-224-1998
Mailing Address - Fax:503-224-5176
Practice Address - Street 1:5200 SW MACADAM AVE STE 100
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3843
Practice Address - Country:US
Practice Address - Phone:503-224-1998
Practice Address - Fax:503-224-5176
Is Sole Proprietor?:No
Enumeration Date:2015-08-21
Last Update Date:2015-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3209225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist