Provider Demographics
NPI:1295884286
Name:HANSEN-LINDSETH, GAIL (LDO)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:HANSEN-LINDSETH
Suffix:
Gender:F
Credentials:LDO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16300 MILL CREEK BLVD
Mailing Address - Street 2:118
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-1737
Mailing Address - Country:US
Mailing Address - Phone:425-742-2900
Mailing Address - Fax:425-745-0740
Practice Address - Street 1:16300 MILL CREEK BLVD
Practice Address - Street 2:118
Practice Address - City:MILL CREEK
Practice Address - State:WA
Practice Address - Zip Code:98012-1737
Practice Address - Country:US
Practice Address - Phone:425-742-2900
Practice Address - Fax:425-745-0740
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA529156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician