Provider Demographics
NPI:1467956391
Name:CRAMER, LYNESE CHRISTINE (ARNP)
Entity Type:Individual
Prefix:
First Name:LYNESE
Middle Name:CHRISTINE
Last Name:CRAMER
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17732 64TH DR NW
Mailing Address - Street 2:
Mailing Address - City:STANWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98292-8965
Mailing Address - Country:US
Mailing Address - Phone:509-818-2865
Mailing Address - Fax:
Practice Address - Street 1:1700 E CHERRY ST STE 200
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4633
Practice Address - Country:US
Practice Address - Phone:425-457-4621
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-23
Last Update Date:2024-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60461421163W00000X
OR202011283NP-PP363LP0808X
WAAP60838566363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1467956391Medicaid