Provider Demographics
NPI:1336555119
Name:LINCOLN, AUSTEN (OTR/L)
Entity Type:Individual
Prefix:
First Name:AUSTEN
Middle Name:
Last Name:LINCOLN
Suffix:
Gender:F
Credentials:OTR/L
Other - Prefix:
Other - First Name:AUSTEN
Other - Middle Name:
Other - Last Name:TAYLOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:OTR/L
Mailing Address - Street 1:2870 NW CORNELL RD
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97210-2421
Mailing Address - Country:US
Mailing Address - Phone:503-720-4634
Mailing Address - Fax:
Practice Address - Street 1:4407 SW STEPHENSON ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97219-7107
Practice Address - Country:US
Practice Address - Phone:503-720-4634
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-07-01
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60563617225XP0200X
OR288785225XP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XP0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistPediatrics