Provider Demographics
NPI:1841626025
Name:CARR, LINDSAY RAE (LMT, CA)
Entity type:Individual
Prefix:MISS
First Name:LINDSAY
Middle Name:RAE
Last Name:CARR
Suffix:
Gender:F
Credentials:LMT, CA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9026 SW 36TH AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97219-5321
Mailing Address - Country:US
Mailing Address - Phone:971-264-4109
Mailing Address - Fax:
Practice Address - Street 1:114 E HANCOCK ST
Practice Address - Street 2:
Practice Address - City:NEWBERG
Practice Address - State:OR
Practice Address - Zip Code:97132-2822
Practice Address - Country:US
Practice Address - Phone:503-554-0661
Practice Address - Fax:503-554-9126
Is Sole Proprietor?:No
Enumeration Date:2013-09-19
Last Update Date:2013-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR510588994111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor