Provider Demographics
NPI:1750051744
Name:LINDERS, KENDRA NICKELLE (RDH)
Entity Type:Individual
Prefix:
First Name:KENDRA
Middle Name:NICKELLE
Last Name:LINDERS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4715 6TH AVE NW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-4425
Mailing Address - Country:US
Mailing Address - Phone:206-250-2335
Mailing Address - Fax:
Practice Address - Street 1:2101 N 34TH ST STE 160
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-9159
Practice Address - Country:US
Practice Address - Phone:206-632-0675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-20
Last Update Date:2021-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH60774303124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WADH60774303OtherDENTAL HYGIENE LICENSE