Healthcare Provider Details

I. General information

NPI: 1508297847
Provider Name (Legal Business Name): LINDSAY LYONS RDH, EFDA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2013
Last Update Date: 01/20/2026
Certification Date: 01/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3049 NE CLEVELAND AVE
GRESHAM OR
97030-2952
US

IV. Provider business mailing address

3049 NE CLEVELAND AVE
GRESHAM OR
97030-2952
US

V. Phone/Fax

Practice location:
  • Phone: 503-473-6838
  • Fax:
Mailing address:
  • Phone: 503-473-6838
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code126800000X
TaxonomyDental Assistant
License Number118921
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License NumberH9027
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: