Provider Demographics
NPI:1407195365
Name:BUCHANAN, LINDSAY (LAC, MAC, DIPLAC)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:
Last Name:BUCHANAN
Suffix:
Gender:F
Credentials:LAC, MAC, DIPLAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4639 NE GOING ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97218-1629
Mailing Address - Country:US
Mailing Address - Phone:503-680-1011
Mailing Address - Fax:
Practice Address - Street 1:5010 NE 33RD AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97211-6946
Practice Address - Country:US
Practice Address - Phone:503-680-1011
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-02-12
Last Update Date:2013-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00892171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist