Provider Demographics
NPI:1417976770
Name:CONLIN, CYNTHIA LYNN (LAC)
Entity Type:Individual
Prefix:MRS
First Name:CYNTHIA
Middle Name:LYNN
Last Name:CONLIN
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:PO BOX 71
Mailing Address - Street 2:
Mailing Address - City:BRIGHTWOOD
Mailing Address - State:OR
Mailing Address - Zip Code:97011-0071
Mailing Address - Country:US
Mailing Address - Phone:503-622-6234
Mailing Address - Fax:
Practice Address - Street 1:38971 PIONEER BLVD
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:OR
Practice Address - Zip Code:97055-8080
Practice Address - Country:US
Practice Address - Phone:503-826-0141
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORAC00915171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist