Provider Demographics
NPI:1063541449
Name:LINDQUIST, SCOTT M (DC)
Entity type:Individual
Prefix:
First Name:SCOTT
Middle Name:M
Last Name:LINDQUIST
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1207 NW BLVD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-4469
Mailing Address - Country:US
Mailing Address - Phone:509-326-2570
Mailing Address - Fax:509-326-2571
Practice Address - Street 1:1207 NW BLVD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99205-4469
Practice Address - Country:US
Practice Address - Phone:509-326-2570
Practice Address - Fax:509-326-2571
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-03
Last Update Date:2008-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002604111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAU20870Medicare UPIN
WAGAB28525Medicare PIN