Provider Demographics
NPI:1790077345
Name:LYNN M OKITA ARNP PLLC
Entity Type:Organization
Organization Name:LYNN M OKITA ARNP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:M
Authorized Official - Last Name:OKITA
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:360-359-7013
Mailing Address - Street 1:703 LILLY RD NE
Mailing Address - Street 2:SUITE 101
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5191
Mailing Address - Country:US
Mailing Address - Phone:360-359-7013
Mailing Address - Fax:
Practice Address - Street 1:703 LILLY RD NE
Practice Address - Street 2:SUITE 101
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5191
Practice Address - Country:US
Practice Address - Phone:360-359-7013
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-13
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WIAP30007796363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAAP30007796OtherSTATE LICENSE