Provider Demographics
NPI:1326270141
Name:MISHKO, LYNDSAY JANE (DC)
Entity Type:Individual
Prefix:
First Name:LYNDSAY
Middle Name:JANE
Last Name:MISHKO
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:415 N SEQUIM AVE
Mailing Address - Street 2:
Mailing Address - City:SEQUIM
Mailing Address - State:WA
Mailing Address - Zip Code:98382-3460
Mailing Address - Country:US
Mailing Address - Phone:360-683-8844
Mailing Address - Fax:360-683-5381
Practice Address - Street 1:415 N SEQUIM AVE
Practice Address - Street 2:
Practice Address - City:SEQUIM
Practice Address - State:WA
Practice Address - Zip Code:98382-3460
Practice Address - Country:US
Practice Address - Phone:360-683-8844
Practice Address - Fax:360-683-5381
Is Sole Proprietor?:No
Enumeration Date:2009-08-12
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH60089448111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0252823OtherL&I