Provider Demographics
NPI:1235982190
Name:SOCOTCH, LINDSAY YARD (CCC-SLP)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:YARD
Last Name:SOCOTCH
Suffix:
Gender:F
Credentials:CCC-SLP
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:RAE
Other - Last Name:YARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12402 NE MARX ST BLDG 3
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97230-1053
Mailing Address - Country:US
Mailing Address - Phone:503-256-6500
Mailing Address - Fax:
Practice Address - Street 1:12402 NE MARX ST BLDG 3
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97230-1053
Practice Address - Country:US
Practice Address - Phone:503-256-6500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-10
Last Update Date:2024-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR015390235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist