Provider Demographics
NPI:1083892772
Name:FAUST, LINDA CATHERINE (LAC)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:CATHERINE
Last Name:FAUST
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1802
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97075-1802
Mailing Address - Country:US
Mailing Address - Phone:503-523-6512
Mailing Address - Fax:
Practice Address - Street 1:1975 NW 167TH PL
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-4908
Practice Address - Country:US
Practice Address - Phone:503-523-6512
Practice Address - Fax:877-254-6910
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-05
Last Update Date:2019-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00189171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist