Provider Demographics
NPI:1831373018
Name:LYNN ALBERTSON ARNP PS
Entity type:Organization
Organization Name:LYNN ALBERTSON ARNP PS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MS
Authorized Official - First Name:LYNN
Authorized Official - Middle Name:
Authorized Official - Last Name:ALBERTSON
Authorized Official - Suffix:
Authorized Official - Credentials:ARNP
Authorized Official - Phone:425-415-8300
Mailing Address - Street 1:13110 NE 177TH PL
Mailing Address - Street 2:B102
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-5740
Mailing Address - Country:US
Mailing Address - Phone:425-415-8300
Mailing Address - Fax:
Practice Address - Street 1:13110 NE 177TH PL
Practice Address - Street 2:B102
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-5740
Practice Address - Country:US
Practice Address - Phone:206-369-6636
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-23
Last Update Date:2012-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA363LF0000XMedicaid
WAG8871695Medicare PIN