Provider Demographics
NPI:1659674851
Name:FARISH, LINDSAY RAE (DPT)
Entity Type:Individual
Prefix:
First Name:LINDSAY
Middle Name:RAE
Last Name:FARISH
Suffix:
Gender:F
Credentials:DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4017 M AVE
Mailing Address - Street 2:
Mailing Address - City:ANACORTES
Mailing Address - State:WA
Mailing Address - Zip Code:98221-3549
Mailing Address - Country:US
Mailing Address - Phone:937-206-8562
Mailing Address - Fax:
Practice Address - Street 1:35 NW 1ST STREET
Practice Address - Street 2:
Practice Address - City:COUPEVILLE
Practice Address - State:WA
Practice Address - Zip Code:98239
Practice Address - Country:US
Practice Address - Phone:360-678-1200
Practice Address - Fax:360-678-1300
Is Sole Proprietor?:No
Enumeration Date:2010-12-09
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WVPT 002870225100000X
WAPT60530485225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WVQ38248AMedicare PIN