Provider Demographics
NPI:1346519329
Name:GRODE, LINDSAY N (LMP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:N
Last Name:GRODE
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:N
Other - Last Name:BARNETT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:1958 CASTLEROCK
Mailing Address - Street 2:
Mailing Address - City:WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98801
Mailing Address - Country:US
Mailing Address - Phone:509-679-4640
Mailing Address - Fax:
Practice Address - Street 1:667 GRANT ROAD
Practice Address - Street 2:SUITE 3
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802
Practice Address - Country:US
Practice Address - Phone:509-679-4640
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-21
Last Update Date:2011-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA#00024959225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist