Tim Lundgren

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

015882 Issued in OR

Practice address

400 E Scenic Dr Ste 207
The Dalles, OR 97058-3447

Phone

(541) 298-5155

NPI assigned

May 1, 2024

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1714521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714521600000",
    "number": "1346097151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1142 CANYON WAY",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970589532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 E SCENIC DR STE 207",
            "city": "THE DALLES",
            "state": "OR",
            "postal_code": "970583447",
            "telephone_number": "541-298-5155"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNDGREN",
        "first_name": "TIM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-05-01",
        "last_updated": "2024-05-01",
        "certification_date": "2024-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OR",
            "license": "015882",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Lopez
• Stefanie Joy Lowe, DC, MS
• John R Lucero
• Joseph Lucia
• Sharon Marie Lucia
• Debra Lynn Lutje, LMT, CMT
• Brian Christian Macarthur, M.D.
• Katrina Mace
• David A Mack, D.O.
• Dennis Keith Macnab, DMD

• Speech-Language Pathologist in The Dalles, OR
• Providers in The Dalles, OR by specialty
• Speech-Language Pathologist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.