Provider Demographics
NPI:1083247993
Name:PERRY, LINDA
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:
Last Name:PERRY
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 1:13096 ROAD A.3 NW
Mailing Address - Street 2:
Mailing Address - City:EPHRATA
Mailing Address - State:WA
Mailing Address - Zip Code:98823-7866
Mailing Address - Country:US
Mailing Address - Phone:509-431-0530
Mailing Address - Fax:
Practice Address - Street 1:216 MARINGO RD
Practice Address - Street 2:
Practice Address - City:EPHRATA
Practice Address - State:WA
Practice Address - Zip Code:98823-1528
Practice Address - Country:US
Practice Address - Phone:509-431-0530
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-02-19
Last Update Date:2020-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health