Provider Demographics
NPI:1285980623
Name:HENDRICKS, LINDSAY MARIE (OD)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:MARIE
Last Name:HENDRICKS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20669 BOND RD NE
Mailing Address - Street 2:STE 100
Mailing Address - City:POULSBO
Mailing Address - State:WA
Mailing Address - Zip Code:98370-6525
Mailing Address - Country:US
Mailing Address - Phone:360-779-2020
Mailing Address - Fax:360-779-3093
Practice Address - Street 1:20669 BOND RD NE
Practice Address - Street 2:STE 100
Practice Address - City:POULSBO
Practice Address - State:WA
Practice Address - Zip Code:98370-6525
Practice Address - Country:US
Practice Address - Phone:360-779-2020
Practice Address - Fax:360-779-3093
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-02
Last Update Date:2018-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAOD60365472152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist