Individual provider · Type 1 NPI

Ethan Thompson

Peer Specialist · Roseburg, OR

NPI number 1346005279 Active

Practice location

621 W Madrone St
Roseburg, OR 97470-3090

Call (541) 672-2691 Map

Mailing address

PO Box 1121
Roseburg, OR 97470-0254

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XNone listed
Case Manager/Care Coordinator 171M00000XNone listed
Peer Specialist Primary 175T00000XNone listed

Peer Specialist: Individuals certified to perform peer support services through a training process defined by a government agency, such as the Department of Veterans Affairs or a state mental health department/certification/licensing authority.

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About NPI 1346005279

Ethan Thompson's National Provider Identifier is 1346005279, issued on Feb 20, 2024. The primary taxonomy on file is Peer Specialist (175T00000X), and the practice location is in Roseburg, OR. The record was last updated on Feb 20, 2024.