Provider Demographics
NPI:1033306899
Name:STEDMAN, LYNN D (RDH, BS, MED, MA)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:D
Last Name:STEDMAN
Suffix:
Gender:F
Credentials:RDH, BS, MED, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 ROSEMARY STREET
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99352-8511
Mailing Address - Country:US
Mailing Address - Phone:509-366-1023
Mailing Address - Fax:
Practice Address - Street 1:102 ROSEMARY ST
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-8511
Practice Address - Country:US
Practice Address - Phone:509-366-1023
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF00000987106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist