Provider Demographics
NPI:1669600888
Name:LYNCH, NATHAN (PA-C)
Entity type:Individual
Prefix:
First Name:NATHAN
Middle Name:
Last Name:LYNCH
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Gender:
Credentials:PA-C
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Mailing Address - Street 1:2200 NE NEFF RD
Mailing Address - Street 2:#200
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4283
Mailing Address - Country:US
Mailing Address - Phone:541-382-3344
Mailing Address - Fax:541-322-2286
Practice Address - Street 1:1253 NW CANAL BLVD
Practice Address - Street 2:
Practice Address - City:REDMOND
Practice Address - State:OR
Practice Address - Zip Code:97756-1334
Practice Address - Country:US
Practice Address - Phone:541-548-8131
Practice Address - Fax:541-526-6608
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2025-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAPA20373363AS0400X
WAPA60150184363AS0400X
ORPA156399363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0264314OtherSTATE L&I