Provider Demographics
NPI:1134701246
Name:EDDY, LINDSAY RENEE
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:RENEE
Last Name:EDDY
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 1:4920A EVERGREEN WAY
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98203-2827
Mailing Address - Country:US
Mailing Address - Phone:425-252-4109
Mailing Address - Fax:425-258-9445
Practice Address - Street 1:4920A EVERGREEN WAY
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2827
Practice Address - Country:US
Practice Address - Phone:425-252-4109
Practice Address - Fax:425-258-9445
Is Sole Proprietor?:No
Enumeration Date:2021-04-27
Last Update Date:2021-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA00041140183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician