Provider Demographics
NPI:1396746657
Name:LINDSLEY, SKYLER K (MD)
Entity type:Individual
Prefix:
First Name:SKYLER
Middle Name:K
Last Name:LINDSLEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KAREN
Other - Middle Name:L
Other - Last Name:LINDSLEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 749730
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90074-9730
Mailing Address - Country:US
Mailing Address - Phone:855-743-5921
Mailing Address - Fax:302-733-0854
Practice Address - Street 1:21605 76TH AVE W
Practice Address - Street 2:SUITE 100
Practice Address - City:EDMONDS
Practice Address - State:WA
Practice Address - Zip Code:98026-7514
Practice Address - Country:US
Practice Address - Phone:425-640-4300
Practice Address - Fax:425-640-4440
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2021-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000314842085R0001X
AZ310582085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2014075Medicaid
WAP01062304OtherRAILROAD MEDICARE
AZ826498Medicaid
WAG8906226Medicare PIN
AZ826498Medicaid
WAG8906770Medicare PIN