Provider Demographics
NPI:1770841520
Name:NATUROPATHIC MEDICINE DR LYNN MIKEL LLC
Entity Type:Organization
Organization Name:NATUROPATHIC MEDICINE DR LYNN MIKEL LLC
Other - Org Name:NATUROPATHIC MEDICINE LLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:T
Authorized Official - Last Name:MIKEL
Authorized Official - Suffix:
Authorized Official - Credentials:ND
Authorized Official - Phone:206-878-2628
Mailing Address - Street 1:2980 N BEVERLY GLEN CIR
Mailing Address - Street 2:SUITE 100
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90077-1726
Mailing Address - Country:US
Mailing Address - Phone:310-474-9809
Mailing Address - Fax:888-431-8819
Practice Address - Street 1:22014 7TH AVE S
Practice Address - Street 2:SUITE 102
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-6235
Practice Address - Country:US
Practice Address - Phone:206-878-2628
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATUROPATHIC MEDICINE DR LYNN MIKEL LLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2012-04-30
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332900000XSuppliersNon-Pharmacy Dispensing Site