Provider Demographics
NPI:1972676351
Name:LYNCH, STEPHEN J (DC)
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:J
Last Name:LYNCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15329 TIGER MOUNTAIN RD SE
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-8346
Mailing Address - Country:US
Mailing Address - Phone:425-427-8973
Mailing Address - Fax:916-405-4337
Practice Address - Street 1:1315 NW MALL ST STE 2
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98027-8997
Practice Address - Country:US
Practice Address - Phone:425-427-8973
Practice Address - Fax:916-405-4337
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA21044111N00000X
WACH00034694111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC0210440Medicare ID - Type Unspecified