Provider Demographics
NPI:1447775762
Name:REAKES, LINDSEY MARIE (PHARMD, BCACP)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MARIE
Last Name:REAKES
Suffix:
Gender:F
Credentials:PHARMD, BCACP
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:
Other - Last Name:HUTNICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 6149
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97007-0149
Mailing Address - Country:US
Mailing Address - Phone:503-352-8642
Mailing Address - Fax:503-352-8658
Practice Address - Street 1:115 NE MAY LN
Practice Address - Street 2:
Practice Address - City:MCMINNVILLE
Practice Address - State:OR
Practice Address - Zip Code:97128-9272
Practice Address - Country:US
Practice Address - Phone:503-359-5564
Practice Address - Fax:503-357-4371
Is Sole Proprietor?:No
Enumeration Date:2017-08-08
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0016694183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist