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General NPI Number Information
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NPI Number | 1104952399
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Entity Type | Individual
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Provider Name | MICHELLE ANN LINDSTROM LMT
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Gender | Female
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Dates
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Enumeration Date | 02/24/2007
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Last Update Date | 01/19/2018
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Provider Practice Location Address
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Address Line | 19611 7TH AVE NE
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City | POULSBO
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State | WA
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Zip | 98370-7384
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Country | US
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Telephone | 360-779-3285
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Fax |
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Provider Business Mailing Address
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Address Line | 8529 10TH AVE SE
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City | EVERETT
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State | WA
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Zip | 98208-2034
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Country | US
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Telephone | 360-265-7899
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA0005136
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License Number State | WA
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