1386099257 NPI number — LINDSEY TROWBRIDGE LICENSED PROFESSIONA

Table of content: LINDSEY TROWBRIDGE LICENSED PROFESSIONA (NPI 1386099257)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1386099257 NPI number — LINDSEY TROWBRIDGE LICENSED PROFESSIONA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TROWBRIDGE
Provider First Name:
LINDSEY
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LICENSED PROFESSIONA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1386099257
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/10/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1975 NW 167TH PLACE
Provider Second Line Business Mailing Address:
SUITE 100-6
Provider Business Mailing Address City Name:
BEAVERTON
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97006
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
503-208-4798
Provider Business Mailing Address Fax Number:
971-369-7864

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1975 NW 167TH PLACE
Provider Second Line Business Practice Location Address:
SUITE 100-6
Provider Business Practice Location Address City Name:
BEAVERTON
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97006
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
503-208-4798
Provider Business Practice Location Address Fax Number:
971-369-7864
Provider Enumeration Date:
04/28/2016

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YM0800X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 101YM0800X , with the licence number: C6128 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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