Individual
LYDIA ANNE M BARTHOLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
(503) 239-8400
Mailing address
1027 E BURNSIDE ST, PORTLAND, OR 97214-1328
(971) 202-7774
(503) 239-8407
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201250177NP
OR
Other
Enumeration date
10/20/2012
Last updated
03/09/2020
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