Provider Demographics
NPI:1598928574
Name:REINKE, LYNN FOSTER (ARNP PHD)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:FOSTER
Last Name:REINKE
Suffix:
Gender:F
Credentials:ARNP PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC STREET
Mailing Address - Street 2:BOX 357266
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-5095
Mailing Address - Country:US
Mailing Address - Phone:206-616-8993
Mailing Address - Fax:206-543-4955
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:BOX 357266
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-0001
Practice Address - Country:US
Practice Address - Phone:206-616-8993
Practice Address - Fax:206-543-4955
Is Sole Proprietor?:No
Enumeration Date:2008-07-09
Last Update Date:2023-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA001522282163WG0000X
UT12685789-4405363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WG0000XNursing Service ProvidersRegistered NurseGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP30006740OtherNURSE PRACTITIONER LICENSE