Basic Information
Provider Information
NPI: 1740595636
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FIELD
FirstName: LINDSAY
MiddleName: A
NamePrefix: MS.
NameSuffix:  
Credential: FNP, LAC
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9450 SW BARNES RD
Address2: SUITE 100
City: PORTLAND
State: OR
PostalCode: 972256619
CountryCode: US
TelephoneNumber: 5032929560
FaxNumber: 5032929510
Practice Location
Address1: 9450 SW BARNES RD
Address2: SUITE 100
City: PORTLAND
State: OR
PostalCode: 972256619
CountryCode: US
TelephoneNumber: 5032929560
FaxNumber: 5032929510
Other Information
ProviderEnumerationDate: 08/16/2010
LastUpdateDate: 07/17/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000X201050140NPORY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily

No ID Information.


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