1871625830 NPI number — MS. LILIANA DE ALMEIDA LYNN MFT

Table of content: TARA KENYON MS (NPI 1245531532)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1871625830 NPI number — MS. LILIANA DE ALMEIDA LYNN MFT

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
LYNN
Provider First Name:
LILIANA
Provider Middle Name:
DE ALMEIDA
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MFT
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:
1871625830
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/08/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
37875 JASPER LOWELL RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
JASPER
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97438-9751
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
541-747-1235
Provider Business Mailing Address Fax Number:
541-747-4722

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
37875 JASPER LOWELL RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
JASPER
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97438-9751
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
541-747-1235
Provider Business Practice Location Address Fax Number:
541-747-4722
Provider Enumeration Date:
03/12/2007

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: 106H00000X , with the licence number:  T0826 , 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)





Copyright © 2007-2026 www.npivalidator.com