MEDICARE: LINDSAY HUETTMAN

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
1	103TC1900X	Counseling Psychologist	MC 60701783	WA

General Provider Information

NPI Number	:	1962942409
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDSAY HUETTMAN

Provider Business Mailing Address
First Line	:	28128 FLORENCE ACRES RD
Second Line	:
City	:	MONROE
State	:	WA
Zip	:	98272-9574
Country	:	US
Telephone Number	:	360-333-7189
Fax Number	:

Provider Business Practice Location Address
First Line	:	28128 FLORENCE ACRES RD
Second Line	:
City	:	MONROE
State	:	WA
Zip	:	98272-9574
Country	:	US
Telephone Number	:	360-333-7189
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2017
Last Update Date	:	03/02/2017

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