Provider Demographics
NPI:1174191795
Name:HILLENBRAND, LUCINDA ROSE
Entity Type:Individual
Prefix:
First Name:LUCINDA
Middle Name:ROSE
Last Name:HILLENBRAND
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 1:14361 SW BARROWS RD
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-6136
Mailing Address - Country:US
Mailing Address - Phone:415-613-5440
Mailing Address - Fax:
Practice Address - Street 1:14361 SW BARROWS RD
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97007-6136
Practice Address - Country:US
Practice Address - Phone:415-613-5440
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-11
Last Update Date:2021-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORLC-LC10213977174N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174N00000XOther Service ProvidersLactation Consultant, Non-RNGroup - Single Specialty