Provider Demographics
NPI:1497026454
Name:LINDSAY, JENNIFER ELIZABETH (LMT)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:ELIZABETH
Last Name:LINDSAY
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 8902
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042
Mailing Address - Country:US
Mailing Address - Phone:253-656-0078
Mailing Address - Fax:888-292-2235
Practice Address - Street 1:27203 216TH AVE SE STE 10
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-3274
Practice Address - Country:US
Practice Address - Phone:253-656-0078
Practice Address - Fax:888-292-2235
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-23
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA 60263066225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist