Provider Demographics
NPI:1255721742
Name:DINICOLA, LINDSEY ANN (DC)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:ANN
Last Name:DINICOLA
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5825 221ST PL SE
Mailing Address - Street 2:#103
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-8927
Mailing Address - Country:US
Mailing Address - Phone:608-792-6977
Mailing Address - Fax:
Practice Address - Street 1:5825 221ST PL SE
Practice Address - Street 2:#103
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-8927
Practice Address - Country:US
Practice Address - Phone:608-792-6977
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-04
Last Update Date:2015-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH 60531523111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor