Provider Demographics
NPI:1962140103
Name:PICKERING, LINDSAY (DPT, ATC)
Entity type:Individual
Prefix:
First Name:LINDSAY
Middle Name:
Last Name:PICKERING
Suffix:
Gender:F
Credentials:DPT, ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 40TH AVE E
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-2405
Mailing Address - Country:US
Mailing Address - Phone:206-331-1918
Mailing Address - Fax:
Practice Address - Street 1:9725 3RD AVE NE STE 100
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-2049
Practice Address - Country:US
Practice Address - Phone:206-706-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2022-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61273470225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist