Individual
TIM LUNDGREN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 E SCENIC DR STE 207, THE DALLES, OR 97058-3447
(541) 298-5155
Mailing address
1142 CANYON WAY, THE DALLES, OR 97058-9532
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
015882
OR
Other
Enumeration date
05/01/2024
Last updated
05/01/2024
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