Provider Demographics
NPI:1942629738
Name:LINDGREN, KOURTNEE
Entity type:Individual
Prefix:
First Name:KOURTNEE
Middle Name:
Last Name:LINDGREN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 S MAIN ST STE A
Mailing Address - Street 2:
Mailing Address - City:COUPEVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98239-3635
Mailing Address - Country:US
Mailing Address - Phone:360-678-6799
Mailing Address - Fax:
Practice Address - Street 1:205 S MAIN ST STE A
Practice Address - Street 2:
Practice Address - City:COUPEVILLE
Practice Address - State:WA
Practice Address - Zip Code:98239-3635
Practice Address - Country:US
Practice Address - Phone:360-678-6799
Practice Address - Fax:360-678-6654
Is Sole Proprietor?:No
Enumeration Date:2014-04-09
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60846637207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology