Provider Demographics
NPI:1245761774
Name:POPE, LINDSEY (LAC)
Entity Type:Individual
Prefix:MS
First Name:LINDSEY
Middle Name:
Last Name:POPE
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 1:191 S 2ND ST
Mailing Address - Street 2:
Mailing Address - City:SAINT HELENS
Mailing Address - State:OR
Mailing Address - Zip Code:97051-2005
Mailing Address - Country:US
Mailing Address - Phone:971-930-2130
Mailing Address - Fax:
Practice Address - Street 1:833 SE MAIN ST STE 424
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-3433
Practice Address - Country:US
Practice Address - Phone:971-930-2130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-26
Last Update Date:2022-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
133N00000X
ORAC182135171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist
No133N00000XDietary & Nutritional Service ProvidersNutritionist