Provider Demographics
NPI:1225365596
Name:FITZPATRICK, LYNDA LYNELL GIGSTAD (AUD)
Entity type:Individual
Prefix:DR
First Name:LYNDA
Middle Name:LYNELL GIGSTAD
Last Name:FITZPATRICK
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13688 SE WILLINGHAM CT
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-7253
Mailing Address - Country:US
Mailing Address - Phone:503-686-4301
Mailing Address - Fax:
Practice Address - Street 1:9900 SE SUNNYSIDE RD
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-9777
Practice Address - Country:US
Practice Address - Phone:503-571-8095
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-11-07
Last Update Date:2022-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR20988231H00000X
ORHAS-P-579186237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist