Provider Demographics
NPI:1710451307
Name:SIMONDS, LINDSAY (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:
Last Name:SIMONDS
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1630 SW MORRISON ST STE 100
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-1916
Mailing Address - Country:US
Mailing Address - Phone:503-227-7774
Mailing Address - Fax:503-227-7548
Practice Address - Street 1:1630 SW MORRISON ST STE 100
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-1916
Practice Address - Country:US
Practice Address - Phone:503-227-7774
Practice Address - Fax:503-227-7548
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-16
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR64233225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty