Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | AP61130526 | WA |
NPI | 1003412313 |
---|---|
Provider Name | Elizabeth Lynn |
First Address | Freeland, WA 98249-1083 |
Second Address | Langley, WA 98260-8664 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/12/2020 |
Last Update Date | 12/01/2021 |