Provider Demographics
NPI:1568911535
Name:LIND, ANDREW (BA PSYCHOLOGY)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:
Last Name:LIND
Suffix:
Gender:M
Credentials:BA PSYCHOLOGY
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15000 SW MILLIKAN WAY APT 123
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97003-2374
Mailing Address - Country:US
Mailing Address - Phone:503-819-5273
Mailing Address - Fax:
Practice Address - Street 1:5100 SW MACADAM AVE STE 400
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-3854
Practice Address - Country:US
Practice Address - Phone:503-244-5211
Practice Address - Fax:503-244-5506
Is Sole Proprietor?:No
Enumeration Date:2016-09-30
Last Update Date:2016-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor