Provider Demographics
NPI:1376770180
Name:HERRERA, LINDSAY R (LAC, LMP)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:R
Last Name:HERRERA
Suffix:
Gender:F
Credentials:LAC, LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2012 LARRABEE AVE
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-7212
Mailing Address - Country:US
Mailing Address - Phone:360-540-2206
Mailing Address - Fax:
Practice Address - Street 1:1610 GROVER ST
Practice Address - Street 2:SUITE B-2
Practice Address - City:LYNDEN
Practice Address - State:WA
Practice Address - Zip Code:98264-1539
Practice Address - Country:US
Practice Address - Phone:360-540-2206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-18
Last Update Date:2009-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC 60013071171100000X
WAMA 00023479171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist