Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 60947432 | WA |
NPI | 1033614094 |
---|---|
Provider Name | Lyndsey Booker |
First Address | Indianapolis, IN 46260-1972 |
Second Address | Seattle, WA 98195-1972 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2018 |
Last Update Date | 09/05/2019 |