Healthcare Provider Details

I. General information

NPI: 1396746657
Provider Name (Legal Business Name): SKYLER K. LINDSLEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAREN L LINDSLEY M.D.

II. Dates (important events)

Enumeration Date: 08/09/2005
Last Update Date: 05/18/2021
Certification Date: 05/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

21605 76TH AVE W SUITE 100
EDMONDS WA
98026-7514
US

IV. Provider business mailing address

PO BOX 749730
LOS ANGELES CA
90074-9730
US

V. Phone/Fax

Practice location:
  • Phone: 425-640-4300
  • Fax: 425-640-4440
Mailing address:
  • Phone: 855-743-5921
  • Fax: 302-733-0854

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD00031484
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number31058
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: