MEDICARE: LYNNE COON L.P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	C2375	OR

General Provider Information

NPI Number	:	1033221296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNNE COON L.P.C.

Provider Business Mailing Address
First Line	:	1020 SW TAYLOR ST STE 448
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97205-2506
Country	:	US
Telephone Number	:	503-243-2283
Fax Number	:

Provider Business Practice Location Address
First Line	:	1020 SW TAYLOR ST STE 448
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97205-2509
Country	:	US
Telephone Number	:	503-243-2283
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/20/2010

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Directions to “ LYNNE COON L.P.C.” Practice Location

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