Healthcare Provider Details

I. General information

NPI: 1275445595
Provider Name (Legal Business Name): LINDSEY MARIE WELLER PT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4011 TALBOT RD S
RENTON WA
98055-5773
US

IV. Provider business mailing address

4011 TALBOT RD S
RENTON WA
98055-5773
US

V. Phone/Fax

Practice location:
  • Phone: 425-690-3520
  • Fax: 425-690-9520
Mailing address:
  • Phone: 425-690-4577
  • Fax: 425-690-9065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT.70166999
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: