Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MD-16610 | HI |
NPI | 1164721148 |
---|---|
Provider Name | Dr. Luke J Lindley |
First Address | Tacoma, WA 98431-0001 |
Second Address | Tacoma, WA 98431-0001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/03/2011 |
Last Update Date | 16/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1164721148 | STUDENT (01) | HI |
VAD000 | UPIN (01) | HI |