Healthcare Provider Details

I. General information

NPI: 1295398766
Provider Name (Legal Business Name): LINDSEY R ROBINSON
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2019
Last Update Date: 06/22/2023
Certification Date: 06/22/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16144 SE HAPPY VALLEY TOWN CENTER DR STE 101
HAPPY VALLEY OR
97086-4257
US

IV. Provider business mailing address

PO BOX 22075
MILWAUKIE OR
97269-2075
US

V. Phone/Fax

Practice location:
  • Phone: 503-659-4988
  • Fax: 503-698-4018
Mailing address:
  • Phone: 503-659-4988
  • Fax: 503-698-4018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA192335
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: