Provider Demographics
NPI:1679614770
Name:FRENCH, CYDNEY J (LMT)
Entity Type:Individual
Prefix:
First Name:CYDNEY
Middle Name:J
Last Name:FRENCH
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:CJ
Other - Middle Name:
Other - Last Name:FRENCH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMT
Mailing Address - Street 1:4729 SE 71ST AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97206-4460
Mailing Address - Country:US
Mailing Address - Phone:503-957-1090
Mailing Address - Fax:503-236-5480
Practice Address - Street 1:3305 SE DIVISION ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97202-1456
Practice Address - Country:US
Practice Address - Phone:503-957-1090
Practice Address - Fax:503-236-5480
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11848174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist