Provider Demographics
NPI:1306033410
Name:WILLIAMSON, LYNDA K (DO)
Entity Type:Individual
Prefix:DR
First Name:LYNDA
Middle Name:K
Last Name:WILLIAMSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3154 E 29TH AVE STE D
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-4852
Mailing Address - Country:US
Mailing Address - Phone:509-998-3555
Mailing Address - Fax:
Practice Address - Street 1:4511 S GLENROSE RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-1348
Practice Address - Country:US
Practice Address - Phone:509-456-2406
Practice Address - Fax:509-456-2407
Is Sole Proprietor?:No
Enumeration Date:2007-10-02
Last Update Date:2022-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOP00001596208VP0000X, 207Q00000X, 2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain Medicine
No2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0181497OtherL & I
WA1117225Medicaid
WAH04787Medicare UPIN
WA1117225Medicaid