Provider Demographics
NPI:1518180447
Name:LYN, KIRSTEN (LMP)
Entity Type:Individual
Prefix:MS
First Name:KIRSTEN
Middle Name:
Last Name:LYN
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 1:23333 CEDAR WAY
Mailing Address - Street 2:#C 203
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-4304
Mailing Address - Country:US
Mailing Address - Phone:425-280-6411
Mailing Address - Fax:
Practice Address - Street 1:6823 OSWEGO PL NE
Practice Address - Street 2:SUITE #1
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-8415
Practice Address - Country:US
Practice Address - Phone:206-527-9709
Practice Address - Fax:206-526-2991
Is Sole Proprietor?:No
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00016872174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist