Provider Demographics
NPI:1265409916
Name:OSMUNDSEN, LYNN E (MD)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:E
Last Name:OSMUNDSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1498 SE TECH CENTER PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98683-9591
Mailing Address - Country:US
Mailing Address - Phone:360-693-7878
Mailing Address - Fax:360-892-5724
Practice Address - Street 1:1498 SE TECH CENTER PL
Practice Address - Street 2:SUITE 100
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98683-9591
Practice Address - Country:US
Practice Address - Phone:360-693-7878
Practice Address - Fax:360-892-5724
Is Sole Proprietor?:No
Enumeration Date:2006-03-01
Last Update Date:2019-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00031915207VF0040X
WA31915174400000X
ORMD17370207V00000X, 207VF0040X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyUrogynecology and Reconstructive Pelvic Surgery
No174400000XOther Service ProvidersSpecialist
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1088665Medicaid
WA1088665Medicaid
WA8805632Medicare ID - Type Unspecified