Provider Demographics
NPI:1992739361
Name:WATERS, LINDSEY M (RDH)
Entity type:Individual
Prefix:
First Name:LINDSEY
Middle Name:M
Last Name:WATERS
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:LINDSEY
Other - Middle Name:M
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 33RD ST NW
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-9547
Mailing Address - Country:US
Mailing Address - Phone:509-886-9922
Mailing Address - Fax:
Practice Address - Street 1:600 ORONDO AVE
Practice Address - Street 2:STE 1
Practice Address - City:WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98801-2800
Practice Address - Country:US
Practice Address - Phone:509-662-3860
Practice Address - Fax:509-666-4458
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2008-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH00006951124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist