Provider Demographics
NPI:1609007350
Name:HAKALA, LYNN (DC)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:HAKALA
Suffix:
Gender:F
Credentials:DC
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 16635
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97292-0635
Mailing Address - Country:US
Mailing Address - Phone:503-261-3863
Mailing Address - Fax:
Practice Address - Street 1:12019 SE POWELL BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97266-1639
Practice Address - Country:US
Practice Address - Phone:503-261-3863
Practice Address - Fax:866-857-0023
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-29
Last Update Date:2013-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2719111NI0900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111NI0900XChiropractic ProvidersChiropractorInternist