Provider Demographics
NPI:1245247113
Name:WOOD, LYNN MARIE (ARNP, FNP)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:MARIE
Last Name:WOOD
Suffix:
Gender:F
Credentials:ARNP, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2668 E LAKE SAMMAMISH PKWY NE
Mailing Address - Street 2:
Mailing Address - City:SAMMAMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98074-4514
Mailing Address - Country:US
Mailing Address - Phone:425-591-9585
Mailing Address - Fax:
Practice Address - Street 1:2613 NE UNIVERSITY VILLAGE ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98105-5025
Practice Address - Country:US
Practice Address - Phone:206-522-2613
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2009-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP300007225363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8864847Medicare UPIN