Provider Demographics
NPI:1144092859
Name:LINCOLN-LIEN, JACQUELINE ELIZABETH (RN)
Entity type:Individual
Prefix:
First Name:JACQUELINE
Middle Name:ELIZABETH
Last Name:LINCOLN-LIEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12507 103RD STREET CT NW
Mailing Address - Street 2:
Mailing Address - City:GIG HARBOR
Mailing Address - State:WA
Mailing Address - Zip Code:98329-5457
Mailing Address - Country:US
Mailing Address - Phone:805-712-5467
Mailing Address - Fax:
Practice Address - Street 1:12507 103RD STREET CT NW
Practice Address - Street 2:
Practice Address - City:GIG HARBOR
Practice Address - State:WA
Practice Address - Zip Code:98329-5457
Practice Address - Country:US
Practice Address - Phone:805-712-5467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-25
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN61467938163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health