Provider Demographics
NPI:1659554244
Name:NELSON, LINDSEY S (ND)
Entity Type:Individual
Prefix:MS
First Name:LINDSEY
Middle Name:S
Last Name:NELSON
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2766 SW FAIRVIEW BLVD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-5825
Mailing Address - Country:US
Mailing Address - Phone:503-201-1350
Mailing Address - Fax:833-453-1594
Practice Address - Street 1:2766 SW FAIRVIEW BLVD
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-5825
Practice Address - Country:US
Practice Address - Phone:503-201-1350
Practice Address - Fax:833-453-1594
Is Sole Proprietor?:No
Enumeration Date:2007-12-06
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1348175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR019388004OtherBLUE CROSS BLUE SHIELD