Provider Demographics
NPI:1760641104
Name:LYNCH, SUZANNE LOUISE (MPT)
Entity Type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:LOUISE
Last Name:LYNCH
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 NICKERSON ST
Mailing Address - Street 2:SUITE 110
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98109-1654
Mailing Address - Country:US
Mailing Address - Phone:206-402-4732
Mailing Address - Fax:
Practice Address - Street 1:101 NICKERSON ST
Practice Address - Street 2:SUITE 110
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98109-1654
Practice Address - Country:US
Practice Address - Phone:206-402-4732
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2013-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028116-12251X0800X
WA603135982251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic