Provider Demographics
NPI:1407070113
Name:FLYNN, DAWN (ND, LAC)
Entity Type:Individual
Prefix:DR
First Name:DAWN
Middle Name:
Last Name:FLYNN
Suffix:
Gender:F
Credentials:ND, LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1904 3RD AVE STE 917
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1191
Mailing Address - Country:US
Mailing Address - Phone:206-330-8490
Mailing Address - Fax:206-903-0397
Practice Address - Street 1:1904 3RD AVE STE 917
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1191
Practice Address - Country:US
Practice Address - Phone:206-330-8490
Practice Address - Fax:206-903-0397
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-12
Last Update Date:2011-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
WAAC00002747171100000X
WA1400175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath
No171M00000XOther Service ProvidersCase Manager/Care Coordinator
No171100000XOther Service ProvidersAcupuncturist