Provider Demographics
NPI:1003988668
Name:LINN, PAULA L (ARNP)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:L
Last Name:LINN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 NICHOLS ST
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:WA
Mailing Address - Zip Code:99122-9729
Mailing Address - Country:US
Mailing Address - Phone:509-725-7101
Mailing Address - Fax:509-725-2112
Practice Address - Street 1:10 NICHOLS ST
Practice Address - Street 2:
Practice Address - City:DAVENPORT
Practice Address - State:WA
Practice Address - Zip Code:99122-9729
Practice Address - Country:US
Practice Address - Phone:509-725-7101
Practice Address - Fax:509-725-2112
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005756367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9632852Medicaid
WAAP30005756OtherARNP LICENSE NUMBER
WARN00137500OtherRN LICENSE NUMBER
WA0208628OtherLABOR & INDUSTRIES PROVID