Provider Demographics
NPI:1093092587
Name:LINDQUIST, ANN MICHELE (LMP)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:MICHELE
Last Name:LINDQUIST
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3532 SKYLARK LOOP
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98226-7946
Mailing Address - Country:US
Mailing Address - Phone:360-303-8605
Mailing Address - Fax:360-303-8605
Practice Address - Street 1:1114 FINNEGAN WAY
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-6622
Practice Address - Country:US
Practice Address - Phone:360-303-8605
Practice Address - Fax:360-303-8605
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-10
Last Update Date:2012-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00009400225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist