Provider Demographics
NPI:1881108553
Name:LYNCHARD, PERCY LEE III (ARNP)
Entity type:Individual
Prefix:MR
First Name:PERCY
Middle Name:LEE
Last Name:LYNCHARD
Suffix:III
Gender:M
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1320 MERKEL ST NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98516-5424
Mailing Address - Country:US
Mailing Address - Phone:360-918-6856
Mailing Address - Fax:
Practice Address - Street 1:4001 HARRISON AVE NW STE 101
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98502-5084
Practice Address - Country:US
Practice Address - Phone:360-704-2362
Practice Address - Fax:360-350-1445
Is Sole Proprietor?:No
Enumeration Date:2017-11-16
Last Update Date:2021-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60800360363LF0000X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2092375Medicaid
WA395774OtherL&I