Provider Demographics
NPI:1376743450
Name:LINDSTROM, EFFIE JO (RN)
Entity Type:Individual
Prefix:
First Name:EFFIE
Middle Name:JO
Last Name:LINDSTROM
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 M AVE
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-3894
Mailing Address - Country:US
Mailing Address - Phone:360-293-6973
Mailing Address - Fax:
Practice Address - Street 1:2601 M AVE
Practice Address - Street 2:
Practice Address - City:ANACORTES
Practice Address - State:WA
Practice Address - Zip Code:98221-3894
Practice Address - Country:US
Practice Address - Phone:360-293-6973
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-07-18
Last Update Date:2007-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00081886163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant