Provider Demographics
NPI:1932259322
Name:SHEPPARD, LYNNE BUDDE (LAC)
Entity Type:Individual
Prefix:MS
First Name:LYNNE
Middle Name:BUDDE
Last Name:SHEPPARD
Suffix:
Gender:F
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3710 168TH ST NE
Mailing Address - Street 2:SUITE B201
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-8416
Mailing Address - Country:US
Mailing Address - Phone:360-435-4523
Mailing Address - Fax:360-654-8379
Practice Address - Street 1:3710 168TH ST NE
Practice Address - Street 2:SUITE B201
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-8416
Practice Address - Country:US
Practice Address - Phone:360-435-4523
Practice Address - Fax:360-654-8379
Is Sole Proprietor?:No
Enumeration Date:2007-01-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAC00001893171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist