Provider Demographics
NPI:1437423746
Name:RUTHERFORD, LINDSAY ALLISON TAGGART (DPT)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:ALLISON TAGGART
Last Name:RUTHERFORD
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:ALLISON
Other - Last Name:TAGGART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:1519 132ND ST SE
Mailing Address - Street 2:SUITE A
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-7203
Mailing Address - Country:US
Mailing Address - Phone:425-357-9380
Mailing Address - Fax:425-357-9382
Practice Address - Street 1:1519 132ND ST SE
Practice Address - Street 2:SUITE A
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-7203
Practice Address - Country:US
Practice Address - Phone:425-337-9556
Practice Address - Fax:425-357-9186
Is Sole Proprietor?:No
Enumeration Date:2012-03-05
Last Update Date:2012-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60227264225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0291772OtherL & I
WA0291773OtherL & I
WA0291731OtherL & I
WA0291748OtherL & I
WA0291748OtherL & I
WAG8908309Medicare PIN
WA0291773OtherL & I