Provider Demographics
NPI:1841521010
Name:STAVE, LINDSEY MARIE (LINDSEY, RN)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:MARIE
Last Name:STAVE
Suffix:
Gender:F
Credentials:LINDSEY, RN
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 4282
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97123-1957
Mailing Address - Country:US
Mailing Address - Phone:503-523-7512
Mailing Address - Fax:
Practice Address - Street 1:19758 NW DORCHESTER WAY
Practice Address - Street 2:
Practice Address - City:HILLSBORO
Practice Address - State:OR
Practice Address - Zip Code:97124-9049
Practice Address - Country:US
Practice Address - Phone:503-523-7512
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200941422RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse