Provider Demographics
NPI:1407217250
Name:WASKO, LINDSAY (CD(DONA))
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:WASKO
Suffix:
Gender:F
Credentials:CD(DONA)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 22872
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97269-2872
Mailing Address - Country:US
Mailing Address - Phone:971-279-7847
Mailing Address - Fax:
Practice Address - Street 1:12122 SE 39TH AVE
Practice Address - Street 2:APT A
Practice Address - City:MILWAUKIE
Practice Address - State:OR
Practice Address - Zip Code:97222-6005
Practice Address - Country:US
Practice Address - Phone:971-279-7847
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR11391374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula