Provider Demographics
NPI:1467733881
Name:LEWIS, LINDSEY N
Entity Type:Individual
Prefix:
First Name:LINDSEY
Middle Name:N
Last Name:LEWIS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7610 W NOB HILL BLVD UNIT 219
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-5724
Mailing Address - Country:US
Mailing Address - Phone:509-594-1275
Mailing Address - Fax:
Practice Address - Street 1:7610 W NOB HILL BLVD UNIT 219
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98908-5724
Practice Address - Country:US
Practice Address - Phone:509-594-1275
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-08-30
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60250136171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator