Provider Demographics
NPI:1225261720
Name:LUMSDEN, BEN T (OTR/L)
Entity Type:Individual
Prefix:MR
First Name:BEN
Middle Name:T
Last Name:LUMSDEN
Suffix:
Gender:M
Credentials:OTR/L
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17700 NW CORNELL RD
Mailing Address - Street 2:APT. 17
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-3225
Mailing Address - Country:US
Mailing Address - Phone:541-944-7108
Mailing Address - Fax:
Practice Address - Street 1:17700 NW CORNELL RD
Practice Address - Street 2:APT. 17
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97006-3225
Practice Address - Country:US
Practice Address - Phone:541-944-7108
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-31
Last Update Date:2009-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR254226225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist