Provider Demographics
NPI:1336565571
Name:MICHAEL J LYNCH
Entity Type:Organization
Organization Name:MICHAEL J LYNCH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PYSCHIATRIC NURSE PRACITITIONER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:JUDE
Authorized Official - Last Name:LYNCH
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:509-263-5690
Mailing Address - Street 1:2136 W RIVERSIDE AVE
Mailing Address - Street 2:APT 101
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-1444
Mailing Address - Country:US
Mailing Address - Phone:509-263-5690
Mailing Address - Fax:
Practice Address - Street 1:2136 W RIVERSIDE AVE
Practice Address - Street 2:APT 101
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-1444
Practice Address - Country:US
Practice Address - Phone:509-263-5690
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-12
Last Update Date:2014-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60445519363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty