Provider Demographics
NPI:1700535432
Name:WEBER, LINDSEY AMELIA
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:AMELIA
Last Name:WEBER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 SW OAK ST STE 417
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97205-2807
Mailing Address - Country:US
Mailing Address - Phone:971-200-0482
Mailing Address - Fax:
Practice Address - Street 1:917 SW OAK ST STE 417
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97205-2807
Practice Address - Country:US
Practice Address - Phone:971-200-0482
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2024-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORA131371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical