Provider Demographics
NPI:1952355570
Name:SEANEY, LYNN ANN (CRNA)
Entity Type:Individual
Prefix:MS
First Name:LYNN
Middle Name:ANN
Last Name:SEANEY
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:MS
Other - First Name:LYNN
Other - Middle Name:ANN
Other - Last Name:DIERKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNA
Mailing Address - Street 1:PO BOX 3002
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-0302
Mailing Address - Country:US
Mailing Address - Phone:360-414-2000
Mailing Address - Fax:
Practice Address - Street 1:1615 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2367
Practice Address - Country:US
Practice Address - Phone:360-414-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004902,RN0013782367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0229362OtherLABOR & INDUSTRIES
WA9647611Medicaid
OR242855Medicaid
OR242855Medicaid