Provider Demographics
NPI:1740028406
Name:SAUCEDO, LINDSEY R
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:R
Last Name:SAUCEDO
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 1:7185 SW SAGERT ST UNIT 101
Mailing Address - Street 2:
Mailing Address - City:TUALATIN
Mailing Address - State:OR
Mailing Address - Zip Code:97062-8256
Mailing Address - Country:US
Mailing Address - Phone:909-244-4271
Mailing Address - Fax:
Practice Address - Street 1:1901 N ESTHER ST
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-9529
Practice Address - Country:US
Practice Address - Phone:855-809-0971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-17
Last Update Date:2024-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program