Provider Demographics
NPI:1649591462
Name:LINGER, NICHOLAS GARY (LMT)
Entity Type:Individual
Prefix:MR
First Name:NICHOLAS
Middle Name:GARY
Last Name:LINGER
Suffix:
Gender:M
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26826 NE KENNEDY DR
Mailing Address - Street 2:
Mailing Address - City:DUVALL
Mailing Address - State:WA
Mailing Address - Zip Code:98019-8416
Mailing Address - Country:US
Mailing Address - Phone:425-508-9288
Mailing Address - Fax:
Practice Address - Street 1:15315 1ST AVE NE STE 211
Practice Address - Street 2:
Practice Address - City:DUVALL
Practice Address - State:WA
Practice Address - Zip Code:98019-5005
Practice Address - Country:US
Practice Address - Phone:425-508-9288
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-15
Last Update Date:2024-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60155527174400000X, 225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
No174400000XOther Service ProvidersSpecialist