Provider Demographics
NPI:1013662873
Name:UPTON, LYNDSEY CLAIRE (MED, NCC, PCA)
Entity Type:Individual
Prefix:
First Name:LYNDSEY
Middle Name:CLAIRE
Last Name:UPTON
Suffix:
Gender:F
Credentials:MED, NCC, PCA
Other - Prefix:
Other - First Name:LYNDSEY
Other - Middle Name:CLAIRE
Other - Last Name:FISHER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MED, NCC, PCA
Mailing Address - Street 1:9450 SW GEMINI DR
Mailing Address - Street 2:PMB 62871
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97008
Mailing Address - Country:US
Mailing Address - Phone:971-832-9052
Mailing Address - Fax:
Practice Address - Street 1:9450 SW GEMINI DR
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97008
Practice Address - Country:US
Practice Address - Phone:971-832-9052
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-19
Last Update Date:2023-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORR8240101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional