Provider Demographics
NPI:1679806848
Name:KOLYNN SINCLAIR, MN, ARNP, BC, PLLC
Entity Type:Organization
Organization Name:KOLYNN SINCLAIR, MN, ARNP, BC, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KOLYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:SINCLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:509-249-0105
Mailing Address - Street 1:1450 N 16TH AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-1381
Mailing Address - Country:US
Mailing Address - Phone:509-249-0105
Mailing Address - Fax:509-249-0035
Practice Address - Street 1:1450 N 16TH AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-1381
Practice Address - Country:US
Practice Address - Phone:509-249-0105
Practice Address - Fax:509-249-0035
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-04
Last Update Date:2009-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30005041364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, AdultGroup - Single Specialty