Basic Information
Provider Information
NPI: 1518271659
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: MILKS
FirstName: LINDSAY
MiddleName: D
NamePrefix:  
NameSuffix:  
Credential: AUD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: FULFS
OtherFirstName: LINDSAY
OtherMiddleName: D
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType: 1
Mailing Information
Address1: PO BOX 421
Address2:  
City: LIBERTY LAKE
State: WA
PostalCode: 990190421
CountryCode: US
TelephoneNumber: 8667472455
FaxNumber: 5092277070
Practice Location
Address1: 217 W CATALDO AVE FL 2
Address2:  
City: SPOKANE
State: WA
PostalCode: 992012217
CountryCode: US
TelephoneNumber: 5096242326
FaxNumber: 5097443040
Other Information
ProviderEnumerationDate: 07/30/2010
LastUpdateDate: 10/14/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 10/14/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
231H00000XLD60176995WAY Speech, Language and Hearing Service ProvidersAudiologist 

No ID Information.


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