Provider Demographics
NPI:1083143762
Name:WOOD, LINDSAY (PMHNP-BC)
Entity type:Individual
Prefix:MRS
First Name:LINDSAY
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1519 SE 2ND ST
Mailing Address - Street 2:
Mailing Address - City:ONTARIO
Mailing Address - State:OR
Mailing Address - Zip Code:97914-4322
Mailing Address - Country:US
Mailing Address - Phone:541-709-4008
Mailing Address - Fax:541-920-0054
Practice Address - Street 1:1219 SW 4TH AVE UNIT 1
Practice Address - Street 2:
Practice Address - City:ONTARIO
Practice Address - State:OR
Practice Address - Zip Code:97914-4500
Practice Address - Country:US
Practice Address - Phone:541-709-4008
Practice Address - Fax:541-920-0054
Is Sole Proprietor?:Yes
Enumeration Date:2017-06-07
Last Update Date:2025-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR10018238363LP0808X, 363L00000X, 363LP0808X
OR201501864RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner