Provider Demographics
NPI:1225214927
Name:BETTLES, LYNNE ELIZABETH (FNP-C)
Entity Type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:ELIZABETH
Last Name:BETTLES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:LYNNE
Other - Middle Name:ELIZABETH
Other - Last Name:MATUK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:1112 NEAH DR
Mailing Address - Street 2:
Mailing Address - City:FOX ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98333-9513
Mailing Address - Country:US
Mailing Address - Phone:253-525-7726
Mailing Address - Fax:
Practice Address - Street 1:2420 S UNION AVE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-1322
Practice Address - Country:US
Practice Address - Phone:253-302-9416
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-14
Last Update Date:2023-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201407669NP-PP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily