Ethan Thompson, is a
Peer Specialist based in Roseburg, Oregon. Ethan Thompson is licensed to practice in Oregon (license number ) and his current practice location is
621 W Madrone St, Roseburg, Oregon. He can be reached at his office (for appointments etc.) via phone at
(541) 672-2691.
NPI number for Ethan Thompson is 1346005279 and his current mailing address is Po Box 1121, Roseburg, Oregon. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1346005279.
Healthcare Provider's Profile
| Full Name | Ethan Thompson |
|---|
| Gender | Male |
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| Speciality | Peer Specialist |
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| Location | 621 W Madrone St, Roseburg, Oregon |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1346005279
- Provider Enumeration Date: 02/20/2024
- Last Update Date: 02/20/2024
Medical Identifiers
Medical identifiers for Ethan Thompson such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1346005279 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Secondary |
| 171M00000X | Case Manager/care Coordinator | (* (Not Available)) | Secondary |
| 175T00000X | Peer Specialist | (Oregon) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ethan Thompson is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Ethan Thompson,
Po Box 1121,
Roseburg, OR 97470-0254
Ph: (541) 672-2691 | Ethan Thompson,
621 W Madrone St,
Roseburg, OR 97470-3090
Ph: (541) 672-2691 |
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