Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TA0700X | Adult Development & Aging Psychologist | 1520 | OR |
Y | 103G00000X | Clinical Psychologist | 1520 | OR |
Y | 103TC0700X | Clinical Psychologist | 1520 | OR |
NPI | 1881750032 |
---|---|
Provider Name | Kay Lynette Stradinger |
First Address | Beaverton, OR 97005-4257 |
Second Address | Aurora, OR 97002-8314 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2006 |
Last Update Date | 03/11/2010 |