Provider Demographics
NPI:1235115924
Name:LINDELL, WAYNE E (DC)
Entity type:Individual
Prefix:MR
First Name:WAYNE
Middle Name:E
Last Name:LINDELL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7012 N FIVE MILE RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-4467
Mailing Address - Country:US
Mailing Address - Phone:509-340-0939
Mailing Address - Fax:509-777-2227
Practice Address - Street 1:100 N MULLAN RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-6859
Practice Address - Country:US
Practice Address - Phone:509-340-0939
Practice Address - Fax:509-777-2227
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2015-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACH00002511111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
T44499Medicare UPIN
WAGAB29734Medicare PIN