Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KOREY THIELEKE
Active Sole ProprietorResidential Treatment, Emotionally Disturbed Children · BEAVERTON, OR
Registration Details
- NPI Number
- 1033892526
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 10, 2023 (2.6985503514812 yrs)
- Last Updated
- Aug 10, 2023
- Sole Proprietor
- Yes
Practice Information
- Address
-
16535 SW TUALATIN VALLEY HWYBEAVERTON, OR, 970035143Browse OR providers · Browse ZIP 97003
- Phone
- 5036495651
- Primary Specialty
-
Residential Treatment, Emotionally Disturbed Children
322D00000X
Other Residential Treatment, Emotionally Disturbed Children Providers in BEAVERTON, OR
| Name | Credential | NPI |
|---|---|---|
| ANN WHITTEMORE | MED, MA | 1407531908 |
| ANDREW JOHNATHAN FORD | — | 1679256994 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.