Provider Demographics
NPI:1770341810
Name:GAFFNEY, LYNN MARCUM (BSHCA, SSD, CHW)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:MARCUM
Last Name:GAFFNEY
Suffix:
Gender:
Credentials:BSHCA, SSD, CHW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1155 CLAYTON WAY
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:OR
Mailing Address - Zip Code:97027-1146
Mailing Address - Country:US
Mailing Address - Phone:971-285-7225
Mailing Address - Fax:503-987-7354
Practice Address - Street 1:603 12TH ST
Practice Address - Street 2:
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-1630
Practice Address - Country:US
Practice Address - Phone:503-522-2358
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-12
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OR113516172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes172V00000XOther Service ProvidersCommunity Health Worker
No171M00000XOther Service ProvidersCase Manager/Care CoordinatorGroup - Single Specialty