Provider Demographics
NPI:1497732309
Name:LANGSFORD, LYNN MARIE (ARNP CNM)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:MARIE
Last Name:LANGSFORD
Suffix:
Gender:F
Credentials:ARNP CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6002 N WESTGATE BLVD
Mailing Address - Street 2:STE 230
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406
Mailing Address - Country:US
Mailing Address - Phone:253-761-2244
Mailing Address - Fax:253-761-1040
Practice Address - Street 1:6002 N WESTGATE BLVD
Practice Address - Street 2:STE 230
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406
Practice Address - Country:US
Practice Address - Phone:253-761-2244
Practice Address - Fax:253-761-1040
Is Sole Proprietor?:No
Enumeration Date:2005-12-30
Last Update Date:2011-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00074183163W00000X
WA025804 AP30001892363LX0001X, 367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA9613431Medicaid
WA0270558OtherL&I
WAG8896179OtherMEDICARE
WALA7596OtherREGENCE
WA001002213Medicare ID - Type Unspecified