Provider Demographics
NPI:1215611041
Name:STANLEY, LYNDSIE KATHLEEN (CMA)
Entity type:Individual
Prefix:
First Name:LYNDSIE
Middle Name:KATHLEEN
Last Name:STANLEY
Suffix:
Gender:
Credentials:CMA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4838 RURAL RD SW APT 207
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-6717
Mailing Address - Country:US
Mailing Address - Phone:501-487-8999
Mailing Address - Fax:
Practice Address - Street 1:319 7TH AVE SE STE 201
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98501-1325
Practice Address - Country:US
Practice Address - Phone:253-281-7564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-12
Last Update Date:2025-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACM60902780246QM0706X
175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist
No246QM0706XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyMedical Technologist