Provider Demographics
NPI:1215672282
Name:HAMILTON, LYNETTE DAWN (PSYD, ABPP)
Entity type:Individual
Prefix:
First Name:LYNETTE
Middle Name:DAWN
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:PSYD, ABPP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:520 SW YAMHILL ST STE 428
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-1327
Mailing Address - Country:US
Mailing Address - Phone:503-946-9036
Mailing Address - Fax:503-200-1328
Practice Address - Street 1:520 SW YAMHILL ST STE 428
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-1327
Practice Address - Country:US
Practice Address - Phone:503-946-9036
Practice Address - Fax:503-200-1328
Is Sole Proprietor?:No
Enumeration Date:2022-05-03
Last Update Date:2022-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TF0200XBehavioral Health & Social Service ProvidersPsychologistForensic