Healthcare Provider Details

I. General information

NPI: 1801950795
Provider Name (Legal Business Name): STEVEN G. LUMSDEN, DC P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/22/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

657 NE HOOD AVE
GRESHAM OR
97030-7328
US

IV. Provider business mailing address

657 NE HOOD AVE
GRESHAM OR
97030-7328
US

V. Phone/Fax

Practice location:
  • Phone: 503-661-7811
  • Fax: 503-661-5723
Mailing address:
  • Phone: 503-661-7811
  • Fax: 503-661-5723

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number27-1682
License Number StateOR

VIII. Authorized Official

Name: DR. STEVEN G LUMSDEN
Title or Position: DC
Credential: PRESIDENT
Phone: 503-661-7811