Provider Demographics
NPI:1871183277
Name:URVINA, LYNN (BA)
Entity Type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:URVINA
Suffix:
Gender:F
Credentials:BA
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 14907
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98511-4907
Mailing Address - Country:US
Mailing Address - Phone:360-754-7629
Mailing Address - Fax:360-350-0564
Practice Address - Street 1:6840 CAPITOL BLVD SE BLDG 3
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98501-5513
Practice Address - Country:US
Practice Address - Phone:360-754-7629
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-20
Last Update Date:2021-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator