Provider Demographics
NPI:1174588701
Name:THOMPSON, LINNA A (MS, CCC-SLP)
Entity type:Individual
Prefix:MS
First Name:LINNA
Middle Name:A
Last Name:THOMPSON
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 ARIES LN
Mailing Address - Street 2:
Mailing Address - City:LA GRANDE
Mailing Address - State:OR
Mailing Address - Zip Code:97850-3309
Mailing Address - Country:US
Mailing Address - Phone:541-963-8678
Mailing Address - Fax:
Practice Address - Street 1:91 ARIES LN
Practice Address - Street 2:
Practice Address - City:LA GRANDE
Practice Address - State:OR
Practice Address - Zip Code:97850-3309
Practice Address - Country:US
Practice Address - Phone:541-963-8678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-18
Last Update Date:2018-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORSP014008235Z00000X
AZSLP1411235Z00000X
NM6158235Z00000X
CASP20472235Z00000X
WASLP60679619235Z00000X
IDSP2260235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist