Provider Demographics
NPI:1720459092
Name:ANDREU, LINDSAY (MS CCC-SLP)
Entity type:Individual
Prefix:MISS
First Name:LINDSAY
Middle Name:
Last Name:ANDREU
Suffix:
Gender:F
Credentials:MS CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8814 N SEWARD AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97217-7352
Mailing Address - Country:US
Mailing Address - Phone:650-996-7860
Mailing Address - Fax:
Practice Address - Street 1:17020 SW UPPER BOONES FERRY RD STE 201
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97224-7078
Practice Address - Country:US
Practice Address - Phone:503-894-1539
Practice Address - Fax:971-353-5182
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-13
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
103K00000X
OR016354235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist
No103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst