Provider Demographics
NPI:1992485874
Name:SMALL, LINDSEY (RD)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:
Last Name:SMALL
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 NW MARKET ST APT 505
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-5262
Mailing Address - Country:US
Mailing Address - Phone:509-760-0509
Mailing Address - Fax:
Practice Address - Street 1:1700 WESTLAKE AVE N
Practice Address - Street 2:ST 700
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109
Practice Address - Country:US
Practice Address - Phone:206-283-2220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-24
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered