Provider Demographics
NPI:1093129983
Name:FLYNN, TROY C
Entity Type:Individual
Prefix:MR
First Name:TROY
Middle Name:C
Last Name:FLYNN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1311 S UNION AVE
Mailing Address - Street 2:STE 102
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98405-1959
Mailing Address - Country:US
Mailing Address - Phone:253-759-3555
Mailing Address - Fax:253-759-2988
Practice Address - Street 1:1311 S UNION AVE
Practice Address - Street 2:STE 102
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1959
Practice Address - Country:US
Practice Address - Phone:253-759-3555
Practice Address - Fax:253-759-2988
Is Sole Proprietor?:No
Enumeration Date:2014-06-18
Last Update Date:2014-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAHA60453952237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist