Provider Demographics
NPI:1477070712
Name:BOWLING, LONNIE E
Entity Type:Individual
Prefix:
First Name:LONNIE
Middle Name:E
Last Name:BOWLING
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 COLLEGE ST SE STE A
Mailing Address - Street 2:
Mailing Address - City:LACEY
Mailing Address - State:WA
Mailing Address - Zip Code:98503-5745
Mailing Address - Country:US
Mailing Address - Phone:360-923-0464
Mailing Address - Fax:360-923-2438
Practice Address - Street 1:1110 COLLEGE ST SE STE A
Practice Address - Street 2:
Practice Address - City:LACEY
Practice Address - State:WA
Practice Address - Zip Code:98503-5745
Practice Address - Country:US
Practice Address - Phone:360-923-0464
Practice Address - Fax:360-923-2438
Is Sole Proprietor?:No
Enumeration Date:2017-08-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA621529300OtherOWCP DO'L