Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 224P00000X | Prosthetist | PS00000475 | WA |
NPI | 1427243468 |
---|---|
Provider Name | Andrew J Lind |
First Address | Spokane, WA 99202-6001 |
Second Address | Spokane, WA 99202-6001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/09/2007 |
Last Update Date | 26/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8503740 | (05) | WA |