Provider Demographics
NPI:1346679222
Name:MILLS, LINDSEY JOHANNA (DPT)
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:JOHANNA
Last Name:MILLS
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:JOHANNA
Other - Last Name:BOZICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:405 NW GILMAN BLVD
Practice Address - Street 2:SUITE 200
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-2470
Practice Address - Country:US
Practice Address - Phone:425-392-6804
Practice Address - Fax:425-392-6805
Is Sole Proprietor?:No
Enumeration Date:2013-11-01
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT 60368576225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAG8930793Medicare UPIN