Healthcare Provider Details

I. General information

NPI: 1326405812
Provider Name (Legal Business Name): LINDSAY PICKETT PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/28/2016
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4323 SW ADMIRAL WAY
SEATTLE WA
98116-2422
US

IV. Provider business mailing address

21137 SR 410 E STE I
BONNEY LAKE WA
98391-8775
US

V. Phone/Fax

Practice location:
  • Phone: 253-862-5275
  • Fax: 253-750-5151
Mailing address:
  • Phone: 253-862-5275
  • Fax: 253-750-5151

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA61099023
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: