Provider Demographics
NPI:1831161033
Name:LINDHOLM, DIXIE DONN (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DIXIE
Middle Name:DONN
Last Name:LINDHOLM
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:DIXIE
Other - Middle Name:DONN
Other - Last Name:BRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1811 W 11TH AVE
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-3304
Mailing Address - Country:US
Mailing Address - Phone:808-388-6622
Mailing Address - Fax:
Practice Address - Street 1:4000 W 27TH AVE
Practice Address - Street 2:
Practice Address - City:KENNEWICK
Practice Address - State:WA
Practice Address - Zip Code:99337-2422
Practice Address - Country:US
Practice Address - Phone:509-582-7781
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2010-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK13066183500000X
WAPH60094518183500000X
TX47066183500000X
HIPH2703183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAD 000Medicare UPIN