Individual
LYNN HALLIDAY-ROUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OT
Contact information
Practice address
400 CRATER LAKE AVE, MEDFORD, OR 97504-6808
(541) 613-6505
Mailing address
610 HIGH ST, OREGON CITY, OR 97045-2241
(503) 657-8903
(503) 266-8632
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
225XP0200X
Pediatric Occupational Therapist
Primary
00546291
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
232021
—
OR
Enumeration date
03/08/2007
Last updated
07/17/2025
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