Brian Michael Thatcher

Primary specialty

CounselorTaxonomy code 101Y00000X

License

T-21-612 Issued in OR

Practice address

Lifeworks Northwest, 5415 SW Westgate Drive
Portland, OR 97221

Phone

(503) 645-3581

NPI assigned

Jan 15, 2021

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1610668800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624492800000",
    "number": "1073102869",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "LIFEWORKS NORTHWEST, 14600 NW CORNELL ROAD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972295442",
            "telephone_number": "503-645-3581"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "LIFEWORKS NORTHWEST, 5415 SW WESTGATE DRIVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "97221",
            "telephone_number": "503-645-3581"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THATCHER",
        "first_name": "BRIAN",
        "middle_name": "MICHAEL",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-01-15",
        "last_updated": "2021-06-24",
        "certification_date": "2021-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "OR",
            "license": "T-21-612",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sian Thang
• Gitanjali Puri Thanik, D.D.S.
• Aristomenis Thanos, M.D
• Mrinal Thapliyal, MD
• Makenzie Thatch
• Carl Thatcher, PT
• Francoise Andree Thatcher, CDAC R
• Jessica Lauren Thatcher
• Katrina Thatcher, MS, LPC
• Alexa Nicole Thavorn I, OD

• Counselor in Portland, OR
• Providers in Portland, OR by specialty
• Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.