Provider Demographics
NPI:1700107505
Name:HEYDENRYCH, LINDSAY K (PSYD)
Entity Type:Individual
Prefix:DR
First Name:LINDSAY
Middle Name:K
Last Name:HEYDENRYCH
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 23183
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97281-3183
Mailing Address - Country:US
Mailing Address - Phone:503-810-7951
Mailing Address - Fax:503-406-4963
Practice Address - Street 1:7000 SW HAMPTON ST STE 125
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8317
Practice Address - Country:US
Practice Address - Phone:503-810-7951
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR2079103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical