Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Q00000X | Family Doctor | OP00001665 | WA |
NPI | 1003861519 |
---|---|
Provider Name | Dr. Lyndsey C Rasmussen |
First Address | Issaquah, WA 98027-8621 |
Second Address | Issaquah, WA 98027-8621 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/05/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H53231 | (02) | WA |