Provider Demographics
NPI:1497087068
Name:JOHNSON, LINDSAY J (LMP)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:J
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:115 W MAGNOLIA ST STE 204
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-4300
Mailing Address - Country:US
Mailing Address - Phone:541-215-0233
Mailing Address - Fax:
Practice Address - Street 1:115 W MAGNOLIA ST STE 204
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4300
Practice Address - Country:US
Practice Address - Phone:541-215-0233
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60100118225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist