Provider Demographics
NPI:1124401526
Name:MACDOUGALL, LINDSAY GRAY
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:GRAY
Last Name:MACDOUGALL
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 1:3331 STUYVESANT PLACE NW
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20015-2454
Mailing Address - Country:US
Mailing Address - Phone:202-320-2665
Mailing Address - Fax:
Practice Address - Street 1:3331 STUYVESANT PL NW
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20015-2454
Practice Address - Country:US
Practice Address - Phone:202-320-2665
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-07-02
Last Update Date:2016-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDU02123171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist