Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0203X | Pediatric Critical Care Doctor | MD19763 | OR |
NPI | 1265413041 |
---|---|
Provider Name | James Lindsay |
First Address | Vancouver, WA 98682-0030 |
Second Address | Portland, OR 97227-1623 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/11/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
078993 | (05) | OR |
8198228 | MEDICAID (01) | WA |
F26269 | (02) |