Provider Demographics
NPI:1417262874
Name:BALE, LINSEY LEE (LMP)
Entity Type:Individual
Prefix:
First Name:LINSEY
Middle Name:LEE
Last Name:BALE
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1618 W 6TH ST
Mailing Address - Street 2:
Mailing Address - City:ABERDEEN
Mailing Address - State:WA
Mailing Address - Zip Code:98520-1102
Mailing Address - Country:US
Mailing Address - Phone:360-581-3496
Mailing Address - Fax:
Practice Address - Street 1:501 N BROADWAY ST
Practice Address - Street 2:
Practice Address - City:ABERDEEN
Practice Address - State:WA
Practice Address - Zip Code:98520-3924
Practice Address - Country:US
Practice Address - Phone:360-537-5914
Practice Address - Fax:360-532-1059
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-10
Last Update Date:2010-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60095861174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist