Provider Demographics
NPI:1558656744
Name:STURTEVANT, LINDSAY MEREDITH (DPT)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MEREDITH
Last Name:STURTEVANT
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:MEREDITH
Other - Last Name:RIMMER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPT
Mailing Address - Street 1:790 REMINGTON BLVD
Mailing Address - Street 2:
Mailing Address - City:BOLINGBROOK
Mailing Address - State:IL
Mailing Address - Zip Code:60440-4909
Mailing Address - Country:US
Mailing Address - Phone:630-296-2223
Mailing Address - Fax:630-759-9510
Practice Address - Street 1:6985 COAL CREEK PKWY SE
Practice Address - Street 2:
Practice Address - City:NEWCASTLE
Practice Address - State:WA
Practice Address - Zip Code:98059-3136
Practice Address - Country:US
Practice Address - Phone:425-378-0500
Practice Address - Fax:425-378-8168
Is Sole Proprietor?:No
Enumeration Date:2011-06-15
Last Update Date:2015-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPT60207543225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0291554OtherDEPT. OF LABOR AND INDUSTRIES
WA1558656744Medicaid
WA0291554OtherDEPT. OF LABOR AND INDUSTRIES