Provider Demographics
NPI:1780135889
Name:MILES, LINDSAY MARIE (CMA, PHLEBOTOMY)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MARIE
Last Name:MILES
Suffix:
Gender:F
Credentials:CMA, PHLEBOTOMY
Other - Prefix:
Other - First Name:LINDSAY
Other - Middle Name:MARIE
Other - Last Name:BETANCOURT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3227 S 368TH PL
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:WA
Mailing Address - Zip Code:98001-8839
Mailing Address - Country:US
Mailing Address - Phone:206-637-7389
Mailing Address - Fax:
Practice Address - Street 1:3227 S 368TH PL
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-8839
Practice Address - Country:US
Practice Address - Phone:206-637-7389
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-24
Last Update Date:2016-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VAX2G2Z5F8390200000X
VAA3L5B5F4390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program