Individual
CONNIE RENEE LINDBERG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
10611 CANYON RD E # 167, PUYALLUP, WA 98373-4256
(253) 254-9093
Mailing address
8823 CANYON RD E, PUYALLUP, WA 98371-6300
(253) 446-6471
(253) 446-7042
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
MA00020294
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
#MA00020294
MASSAGE PRACTITIONER LICENSE
WA
Enumeration date
06/02/2011
Last updated
06/02/2011
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