Provider Demographics
NPI:1427370683
Name:STAKER, LINDSAY B (LAC,)
Entity Type:Individual
Prefix:MS
First Name:LINDSAY
Middle Name:B
Last Name:STAKER
Suffix:
Gender:F
Credentials:LAC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:115 4TH AVE S
Mailing Address - Street 2:STE C
Mailing Address - City:EDMONDS
Mailing Address - State:WA
Mailing Address - Zip Code:98020-3515
Mailing Address - Country:US
Mailing Address - Phone:425-778-2838
Mailing Address - Fax:425-640-7423
Practice Address - Street 1:115 4TH AVE S
Practice Address - Street 2:STE C
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98020-3515
Practice Address - Country:US
Practice Address - Phone:425-778-2838
Practice Address - Fax:425-640-7423
Is Sole Proprietor?:No
Enumeration Date:2010-02-15
Last Update Date:2021-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC60123237171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist