Provider Demographics
NPI:1801950795
Name:STEVEN G. LUMSDEN, DC P.C.
Entity type:Organization
Organization Name:STEVEN G. LUMSDEN, DC P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DC
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:G
Authorized Official - Last Name:LUMSDEN
Authorized Official - Suffix:
Authorized Official - Credentials:PRESIDENT
Authorized Official - Phone:503-661-7811
Mailing Address - Street 1:657 NE HOOD AVE
Mailing Address - Street 2:
Mailing Address - City:GRESHAM
Mailing Address - State:OR
Mailing Address - Zip Code:97030-7328
Mailing Address - Country:US
Mailing Address - Phone:503-661-7811
Mailing Address - Fax:503-661-5723
Practice Address - Street 1:657 NE HOOD AVE
Practice Address - Street 2:
Practice Address - City:GRESHAM
Practice Address - State:OR
Practice Address - Zip Code:97030-7328
Practice Address - Country:US
Practice Address - Phone:503-661-7811
Practice Address - Fax:503-661-5723
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27-1682111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
T67862Medicare UPIN
R0000QGCHDMedicare ID - Type Unspecified