Provider Demographics
NPI:1528026820
Name:KOHLMEIER, LYNN A (MD)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:A
Last Name:KOHLMEIER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6506 S DEVONSHIRE CT
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-6230
Mailing Address - Country:US
Mailing Address - Phone:509-998-1045
Mailing Address - Fax:
Practice Address - Street 1:6506 S DEVONSHIRE CT
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-6230
Practice Address - Country:US
Practice Address - Phone:509-998-1045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-15009207RE0101X
WAMD00038025207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8249344Medicaid
ID8056989Medicaid
WAAB11991Medicare ID - Type Unspecified
ID8056989Medicaid