Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | MD60493114 | WA |
N | 208000000X | Pediatrician | 48820 | TN |
N | 208000000X | Pediatrician | MD60493114 | WA |
NPI | 1396988598 |
---|---|
Provider Name | Lindsay Roofe Lavin |
First Address | Tacoma, WA 98405-4234 |
Second Address | Tacoma, WA 98405-4234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2009 |
Last Update Date | 24/09/2015 |