Healthcare Provider Details

I. General information

NPI: 1245473404
Provider Name (Legal Business Name): LINDSAY URBINELLI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/16/2009
Last Update Date: 07/18/2022
Certification Date: 07/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N GRAHAM ST STE 250
PORTLAND OR
97227-1666
US

IV. Provider business mailing address

300 N. GRAHAM ST. SUITE 250
PORTLAND OR
97227
US

V. Phone/Fax

Practice location:
  • Phone: 503-280-3418
  • Fax: 503-284-7885
Mailing address:
  • Phone: 503-280-3418
  • Fax: 503-284-7885

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberMD60685481
License Number StateWA
# 2
Primary TaxonomyY
Taxonomy Code2080P0202X
TaxonomyPediatric Cardiology Physician
License NumberMD178875
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: