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NPI Code Detail

MEDICARE: MRS. LINDSEY RAE CLARK

MEDICARE: MRS. LINDSEY RAE CLARK
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183700000XPharmacy TechnicianVA00060731WA

General Provider Information

NPI Number : 1013993724
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. LINDSEY RAE CLARK
Provider Business Mailing Address
First Line : 2222 32ND AVE W
Second Line :
City : SEATTLE
State : WA
Zip : 98199-4044
Country : US
Telephone Number : 206-282-2881
Fax Number : 206-282-2817
Provider Business Practice Location Address
First Line : 2222 32ND AVE W
Second Line :
City : SEATTLE
State : WA
Zip : 98199-4044
Country : US
Telephone Number : 206-282-2881
Fax Number : 206-282-2817
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/15/2005
Last Update Date : 01/05/2012

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Directions to “ MRS. LINDSEY RAE CLARK ” Practice Location

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