Healthcare Provider Details

I. General information

NPI: 1699683094
Provider Name (Legal Business Name): LINDSAY LUCKEY
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3030 NE ALOCLEK DR
HILLSBORO OR
97124-7521
US

IV. Provider business mailing address

13369 PETERS RD
LAKE OSWEGO OR
97035-1330
US

V. Phone/Fax

Practice location:
  • Phone: 503-213-1700
  • Fax:
Mailing address:
  • Phone: 503-614-1267
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number014013
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: