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NPI Code Detail

MEDICARE: LINDSAY MARIE HENDRICKS O.D.

MEDICARE: LINDSAY MARIE HENDRICKS O.D.
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
1152W00000XOptometristOD60365472WA

General Provider Information

NPI Number : 1285980623
Entity Type Code : Individual
Provider Name (Legal Business Name) : LINDSAY MARIE HENDRICKS O.D.
Provider Business Mailing Address
First Line : 20669 BOND RD NE
Second Line : STE 100
City : POULSBO
State : WA
Zip : 98370-6525
Country : US
Telephone Number : 360-779-2020
Fax Number : 360-779-3093
Provider Business Practice Location Address
First Line : 20669 BOND RD NE
Second Line : STE 100
City : POULSBO
State : WA
Zip : 98370-6525
Country : US
Telephone Number : 360-779-2020
Fax Number : 360-779-3093
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/02/2012
Last Update Date : 10/08/2018

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