Provider Demographics
NPI:1972899045
Name:LINCOLN DANG LLC
Entity Type:Organization
Organization Name:LINCOLN DANG LLC
Other - Org Name:APOLLO SALON & SPA
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KHANH
Authorized Official - Middle Name:D
Authorized Official - Last Name:DANG
Authorized Official - Suffix:
Authorized Official - Credentials:ESTHETICIAN
Authorized Official - Phone:206-850-2277
Mailing Address - Street 1:P.O. BOX 913
Mailing Address - Street 2:
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370
Mailing Address - Country:US
Mailing Address - Phone:360-779-9445
Mailing Address - Fax:360-779-8445
Practice Address - Street 1:18980 JENSEN WAY NORTHEAST
Practice Address - Street 2:
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370
Practice Address - Country:US
Practice Address - Phone:360-779-9445
Practice Address - Fax:360-779-8445
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-06-27
Last Update Date:2011-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA602373481225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage TherapistGroup - Single Specialty