Provider Demographics
NPI:1972746014
Name:LYNCH, ARIO D (LMT)
Entity Type:Individual
Prefix:
First Name:ARIO
Middle Name:D
Last Name:LYNCH
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6424 NE GOING ST
Mailing Address - Street 2:UNIT A
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97218-3138
Mailing Address - Country:US
Mailing Address - Phone:503-841-2556
Mailing Address - Fax:
Practice Address - Street 1:436 SE 12TH AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97214-1323
Practice Address - Country:US
Practice Address - Phone:503-841-2556
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-17
Last Update Date:2009-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR14947172M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist