Provider Demographics
NPI:1982981791
Name:MUNSON, LINDA GAY (LAC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:GAY
Last Name:MUNSON
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:312 142ND ST SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-7326
Mailing Address - Country:US
Mailing Address - Phone:425-741-2053
Mailing Address - Fax:
Practice Address - Street 1:210 128TH ST SE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98208-6338
Practice Address - Country:US
Practice Address - Phone:425-337-5100
Practice Address - Fax:425-745-3933
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-08
Last Update Date:2011-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC 00002124171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist