Provider Demographics
NPI:1235353624
Name:DALTON, LYNN A (LMP)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:A
Last Name:DALTON
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13555 BEL-RED RD.
Mailing Address - Street 2:#205
Mailing Address - City:BELLEUVE
Mailing Address - State:WA
Mailing Address - Zip Code:98005
Mailing Address - Country:US
Mailing Address - Phone:425-455-2320
Mailing Address - Fax:425-455-2473
Practice Address - Street 1:13555 BEL RED RD
Practice Address - Street 2:#205
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2397
Practice Address - Country:US
Practice Address - Phone:425-455-2320
Practice Address - Fax:425-455-2473
Is Sole Proprietor?:No
Enumeration Date:2007-04-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00013518225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist