Provider Demographics
NPI:1437191368
Name:HERN, LINDSEY LEE (PA-C)
Entity Type:Individual
Prefix:MRS
First Name:LINDSEY
Middle Name:LEE
Last Name:HERN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MISS
Other - First Name:LINDSEY
Other - Middle Name:LEE
Other - Last Name:HUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:9135 SW BARNES RD STE 963
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97225-6699
Mailing Address - Country:US
Mailing Address - Phone:503-297-1419
Mailing Address - Fax:503-216-2488
Practice Address - Street 1:9135 SW BARNES RD STE 963
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97225-6699
Practice Address - Country:US
Practice Address - Phone:503-297-1419
Practice Address - Fax:503-216-2488
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2021-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010733363AS0400X
ORPA01312363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical