Provider Demographics
NPI:1932459690
Name:LYNCH, JENNIFER AMMA (LMP)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:AMMA
Last Name:LYNCH
Suffix:
Gender:F
Credentials:LMP
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 383
Mailing Address - Street 2:
Mailing Address - City:SEABECK
Mailing Address - State:WA
Mailing Address - Zip Code:98380-0383
Mailing Address - Country:US
Mailing Address - Phone:206-458-5819
Mailing Address - Fax:
Practice Address - Street 1:8537 PHINNEY AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-3705
Practice Address - Country:US
Practice Address - Phone:206-784-9806
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-10
Last Update Date:2012-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA60285030225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist