NPI 1033892526

Korey Thieleke

Practitioner Emotionally Disturbed Childrens' Residential Treatment Facility Beaverton, OR

Practice location

Address: 16535 SW Tualatin Valley Hwy, Beaverton, OR 97003-5143
Phone: (503) 649-5651

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Oregon →

Registry record

NPI: 1033892526
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Aug 2023
Record last updated: 10 Aug 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.