Healthcare Provider Details

I. General information

NPI: 1649381872
Provider Name (Legal Business Name): LYNNEA EILEEN LINDSEY PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: LYNNEA EILEEN LINDSEY-PENGELLY PHD

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 07/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1661 HIGH ST
EUGENE OR
97401-4113
US

IV. Provider business mailing address

1661 HIGH ST
EUGENE OR
97401-4113
US

V. Phone/Fax

Practice location:
  • Phone: 541-343-3433
  • Fax: 541-343-2218
Mailing address:
  • Phone: 541-343-3433
  • Fax: 541-343-2218

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number1246
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: