Individual
DR. LINDSEY R DOUGLAS III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
4207 TIETON DR, YAKIMA, WA 98908-3347
(509) 965-8911
(509) 965-6143
Mailing address
4207 TIETON DR, YAKIMA, WA 98908-3347
(509) 965-8911
(509) 965-6143
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
9059
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5036942
—
WA
Enumeration date
10/24/2006
Last updated
07/08/2007
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