Basic Information
| Provider Information | |||||||||
| NPI: | 1669039434 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LINGMANN | ||||||||
| FirstName: | MATHEW | ||||||||
| MiddleName: | RAY | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | AU. D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 29799 SW CAMELOT ST | ||||||||
| Address2: | |||||||||
| City: | WILSONVILLE | ||||||||
| State: | OR | ||||||||
| PostalCode: | 970707563 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5038831393 | ||||||||
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| Practice Location | |||||||||
| Address1: | 15405 SW 116TH AVE STE 200 | ||||||||
| Address2: | |||||||||
| City: | KING CITY | ||||||||
| State: | OR | ||||||||
| PostalCode: | 972244105 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5036841583 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/28/2019 | ||||||||
| LastUpdateDate: | 05/28/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 231H00000X | 030941 | OR | Y | Speech, Language and Hearing Service Providers | Audiologist |
No ID Information.