Individual
LINGGA ADIDHARMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 598-4022
Mailing address
1959 NE PACIFIC ST, SEATTLE, WA 98195-0001
(206) 598-4022
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
ML.61165617
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2021
Last updated
12/07/2023
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