Provider Demographics
NPI:1013223858
Name:ROHN, LYNN (LMP)
Entity Type:Individual
Prefix:MISS
First Name:LYNN
Middle Name:
Last Name:ROHN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MRS
Other - First Name:DONNA
Other - Middle Name:LYNN
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:2501 SE MILE HILL DR STE A101
Mailing Address - Street 2:
Mailing Address - City:PORT ORCHARD
Mailing Address - State:WA
Mailing Address - Zip Code:98366-3514
Mailing Address - Country:US
Mailing Address - Phone:360-895-4843
Mailing Address - Fax:
Practice Address - Street 1:2501 SE MILE HILL DR STE A101
Practice Address - Street 2:
Practice Address - City:PORT ORCHARD
Practice Address - State:WA
Practice Address - Zip Code:98366-3514
Practice Address - Country:US
Practice Address - Phone:360-895-4843
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-30
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60176340174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist