Provider Demographics
NPI:1568030294
Name:TEENY, LYNETTE (RN)
Entity Type:Individual
Prefix:
First Name:LYNETTE
Middle Name:
Last Name:TEENY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4517 N 13TH ST
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98406-3703
Mailing Address - Country:US
Mailing Address - Phone:253-380-4378
Mailing Address - Fax:
Practice Address - Street 1:17306 SMOKEY POINT DR STE 21
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-4707
Practice Address - Country:US
Practice Address - Phone:360-322-7626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-06-17
Last Update Date:2021-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00101797163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163W00000XNursing Service ProvidersRegistered NurseGroup - Single Specialty