Provider Demographics
NPI:1881750032
Name:STRADINGER, KAY LYNETTE (PSYD)
Entity type:Individual
Prefix:
First Name:KAY
Middle Name:LYNETTE
Last Name:STRADINGER
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:KAY
Other - Middle Name:STRADINGER
Other - Last Name:YOHO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:5170 SW CHESTNUT AVE
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97005-4257
Mailing Address - Country:US
Mailing Address - Phone:971-227-6193
Mailing Address - Fax:503-643-3833
Practice Address - Street 1:27332 S MERIDIAN RD
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:OR
Practice Address - Zip Code:97002-8314
Practice Address - Country:US
Practice Address - Phone:971-227-6193
Practice Address - Fax:503-678-6971
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR1520103TC0700X, 103TA0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
No103TA0700XBehavioral Health & Social Service ProvidersPsychologistAdult Development & Aging