Provider Demographics
NPI:1114643665
Name:HAIGHT, JUDITH LEE (3747A0650 TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:LEE
Last Name:HAIGHT
Suffix:
Gender:F
Credentials:3747A0650 TECHNICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18910 40TH AVE W
Mailing Address - Street 2:
Mailing Address - City:LYNNWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98036-5603
Mailing Address - Country:US
Mailing Address - Phone:425-210-7267
Mailing Address - Fax:
Practice Address - Street 1:18910 40TH AVE W
Practice Address - Street 2:
Practice Address - City:LYNNWOOD
Practice Address - State:WA
Practice Address - Zip Code:98036-5603
Practice Address - Country:US
Practice Address - Phone:425-210-7267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-17
Last Update Date:2022-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider