Provider Demographics
NPI:1790992493
Name:COMPTON, LYNNE POWELL
Entity Type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:POWELL
Last Name:COMPTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:LYNNE
Other - Middle Name:DAPHNE
Other - Last Name:COMPTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMP
Mailing Address - Street 1:400 E PINE ST
Mailing Address - Street 2:SUITE 220
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2316
Mailing Address - Country:US
Mailing Address - Phone:206-366-8757
Mailing Address - Fax:
Practice Address - Street 1:400 E PINE ST
Practice Address - Street 2:SUITE 220
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-2316
Practice Address - Country:US
Practice Address - Phone:206-366-8757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00004603225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA55707OtherLABOR AND INDUSTRIES