Provider Demographics
NPI:1053475921
Name:SIMS, LINDA G (MED)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:G
Last Name:SIMS
Suffix:
Gender:F
Credentials:MED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20B N TACOMA AVE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98403-3125
Mailing Address - Country:US
Mailing Address - Phone:253-404-0501
Mailing Address - Fax:253-272-2188
Practice Address - Street 1:20B N TACOMA AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98403-3125
Practice Address - Country:US
Practice Address - Phone:253-404-0501
Practice Address - Fax:253-272-2188
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00004892101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health