Provider Demographics
NPI:1053658096
Name:WILKINSON, LINDSAY ANNE MARIE (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:ANNE MARIE
Last Name:WILKINSON
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:DR
Other - First Name:LINDSAY
Other - Middle Name:ANNE MARIE
Other - Last Name:BAKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:16512 SE MARKET ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97233-4018
Mailing Address - Country:US
Mailing Address - Phone:971-703-9099
Mailing Address - Fax:
Practice Address - Street 1:6118 SE BELMONT ST STE 511
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97215-1983
Practice Address - Country:US
Practice Address - Phone:971-220-2169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-01-10
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR4021175F00000X, 175F00000X
OR179280171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171100000XOther Service ProvidersAcupuncturist