Provider Demographics
NPI:1336297985
Name:LINTON NELSON, LORI LYNETTE (PMHNP)
Entity Type:Individual
Prefix:MRS
First Name:LORI
Middle Name:LYNETTE
Last Name:LINTON NELSON
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:27332 S MERIDIAN RD
Mailing Address - Street 2:
Mailing Address - City:AURORA
Mailing Address - State:OR
Mailing Address - Zip Code:97002-8314
Mailing Address - Country:US
Mailing Address - Phone:503-678-6946
Mailing Address - Fax:503-585-4908
Practice Address - Street 1:3180 CENTER ST NE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-4532
Practice Address - Country:US
Practice Address - Phone:503-588-5351
Practice Address - Fax:503-585-4908
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-08
Last Update Date:2013-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR086000481N6-PMHNP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORS91812Medicare UPIN