Provider Demographics
NPI:1205406212
Name:ATCHISON, LINDSEY RAE (CPHT)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:RAE
Last Name:ATCHISON
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3282 BETHEL RD SE
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-5603
Mailing Address - Country:US
Mailing Address - Phone:360-876-0969
Mailing Address - Fax:360-876-9114
Practice Address - Street 1:3282 BETHEL RD SE
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-5603
Practice Address - Country:US
Practice Address - Phone:360-876-0969
Practice Address - Fax:360-876-9114
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2021-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA60330763183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician