Provider Demographics
NPI:1598815946
Name:THOMAS, LINDY A (OD)
Entity Type:Individual
Prefix:DR
First Name:LINDY
Middle Name:A
Last Name:THOMAS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2300 NE BROADWAY ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97232-1611
Mailing Address - Country:US
Mailing Address - Phone:503-284-2300
Mailing Address - Fax:503-284-2347
Practice Address - Street 1:2300 NE BROADWAY ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1611
Practice Address - Country:US
Practice Address - Phone:503-284-2300
Practice Address - Fax:503-284-2347
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2013-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV350152W00000X
OR3293AT152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVCC8156OtherBCBS PROVIDER ID
NV410049319OtherRAILROAD MEDICARE
NV002502046Medicaid
NV410049319OtherRAILROAD MEDICARE
NVU73747Medicare UPIN
NVV38509Medicare PIN