Provider Demographics
NPI:1629160536
Name:LINCOLN, NARAYAN L (PMHNP)
Entity Type:Individual
Prefix:MS
First Name:NARAYAN
Middle Name:L
Last Name:LINCOLN
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3835 SW KELLY AVE #240
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97239-4312
Mailing Address - Country:US
Mailing Address - Phone:503-293-8378
Mailing Address - Fax:503-245-2989
Practice Address - Street 1:3835 SW KELLY AVE #240
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97239-4312
Practice Address - Country:US
Practice Address - Phone:503-293-8378
Practice Address - Fax:503-245-2989
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2015-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR000028900N6 PMHNP-PP363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
ORR131902Medicare ID - Type Unspecified