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General NPI Number Information
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NPI Number | 1356259204
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Entity Type | Individual
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Provider Name | ALICIA LYNN LUNDQUIST HIS
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Gender | Female
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Dates
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Enumeration Date | 08/31/2026
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Last Update Date | 08/31/2026
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Provider Practice Location Address
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Address Line | 827 E COLONIAL AVE STE A
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City | MOSES LAKE
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State | WA
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Zip | 98837-4644
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Country | US
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Telephone | 509-765-4467
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Fax | 509-764-0662
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Provider Business Mailing Address
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Address Line | 827 E COLONIAL AVE STE A
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City | MOSES LAKE
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State | WA
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Zip | 98837-4644
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Country | US
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Telephone | 509-765-4467
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Fax | 509-764-0662
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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 | 237700000X
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Taxonomy Name | Hearing Instrument Specialist
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License Number | 70114748
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License Number State | WA
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