Provider Demographics
NPI:1043692122
Name:LUCIA, LINDSEY
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:LUCIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2010 SE SHERMAN ST
Mailing Address - Street 2:APT. 8
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97214-5470
Mailing Address - Country:US
Mailing Address - Phone:707-478-6609
Mailing Address - Fax:
Practice Address - Street 1:2010 SE SHERMAN ST
Practice Address - Street 2:APT. 8
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-5470
Practice Address - Country:US
Practice Address - Phone:707-478-6609
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program