Provider Demographics
NPI:1477532406
Name:FLYNN, CYNTHIA B (CNM, PHD)
Entity Type:Individual
Prefix:DR
First Name:CYNTHIA
Middle Name:B
Last Name:FLYNN
Suffix:
Gender:F
Credentials:CNM, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:424 S WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99336-3950
Mailing Address - Country:US
Mailing Address - Phone:509-586-6248
Mailing Address - Fax:509-586-7928
Practice Address - Street 1:801 17TH ST NE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-7200
Practice Address - Country:US
Practice Address - Phone:509-586-6248
Practice Address - Fax:509-586-7928
Is Sole Proprietor?:No
Enumeration Date:2006-01-09
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003949367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9617895Medicaid