Provider Demographics
NPI:1154322105
Name:LYNCH, JESSICA ANN (OD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:ANN
Last Name:LYNCH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2721 STRASBURG DR
Mailing Address - Street 2:
Mailing Address - City:FOREST GROVE
Mailing Address - State:OR
Mailing Address - Zip Code:97116-2252
Mailing Address - Country:US
Mailing Address - Phone:503-504-4989
Mailing Address - Fax:
Practice Address - Street 1:6506 NE CAMPUS WAY
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-7454
Practice Address - Country:US
Practice Address - Phone:503-640-2020
Practice Address - Fax:503-640-1162
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2014-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2879AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist