Provider Demographics
NPI:1679832026
Name:GILL, LYN (LMP)
Entity Type:Individual
Prefix:
First Name:LYN
Middle Name:
Last Name:GILL
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 1:325 WASHINGTON AVE S
Mailing Address - Street 2:#380
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98032-5767
Mailing Address - Country:US
Mailing Address - Phone:206-849-0311
Mailing Address - Fax:
Practice Address - Street 1:325 WASHINGTON AVE S
Practice Address - Street 2:#380
Practice Address - City:KENT
Practice Address - State:WA
Practice Address - Zip Code:98032-5767
Practice Address - Country:US
Practice Address - Phone:206-849-0311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-04
Last Update Date:2012-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist