Provider Demographics
NPI:1447546957
Name:LANGHAM, LINDSAY (PHARMD)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:LANGHAM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:
Other - Last Name:CORTEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7600 SW DARTMOUTH ST
Mailing Address - Street 2:
Mailing Address - City:TIGARD
Mailing Address - State:OR
Mailing Address - Zip Code:97223-8181
Mailing Address - Country:US
Mailing Address - Phone:503-268-5272
Mailing Address - Fax:
Practice Address - Street 1:7600 SW DARTMOUTH ST
Practice Address - Street 2:
Practice Address - City:TIGARD
Practice Address - State:OR
Practice Address - Zip Code:97223-8181
Practice Address - Country:US
Practice Address - Phone:503-268-5272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2015-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARPH021396183500000X
ORRPH0014569183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist