Provider Demographics
NPI:1134349095
Name:DAVIDSON, LYNN (RN)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:DAVIDSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:RAINWATER-DAVIDSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:12303 NE 130TH LN
Mailing Address - Street 2:STE 420
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98034-3099
Mailing Address - Country:US
Mailing Address - Phone:425-899-6400
Mailing Address - Fax:425-899-4490
Practice Address - Street 1:12303 NE 130TH LN
Practice Address - Street 2:STE 420
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-3099
Practice Address - Country:US
Practice Address - Phone:425-899-6400
Practice Address - Fax:425-899-4490
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor