Provider Demographics
NPI:1043872559
Name:MERCY, LYNDA CLARE
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:CLARE
Last Name:MERCY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3131 SMOKEY POINT DR STE 5B
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-2301
Mailing Address - Country:US
Mailing Address - Phone:360-653-9600
Mailing Address - Fax:360-658-9603
Practice Address - Street 1:3131 SMOKEY POINT DR STE 5B
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-2301
Practice Address - Country:US
Practice Address - Phone:360-653-9600
Practice Address - Fax:360-658-9603
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60958177225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAMA60958177OtherMASSAGE THERAPY