Provider Demographics
NPI:1700187788
Name:BIRKS, LYNN MARIE
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:MARIE
Last Name:BIRKS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 839
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-0839
Mailing Address - Country:US
Mailing Address - Phone:425-212-3993
Mailing Address - Fax:425-259-3073
Practice Address - Street 1:2801 LOMBARD AVE
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3619
Practice Address - Country:US
Practice Address - Phone:425-212-3993
Practice Address - Fax:425-259-3073
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-08
Last Update Date:2010-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other