Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | MD00046337 | WA |
N | 2084N0400X | Neurologist | 33854 | AZ |
N | 2084N0400X | Neurologist | MD00046337 | WA |
N | 2084N0402X | Child Neurologist | MD00046337 | WA |
Y | 2084N0600X | Clinical Neurophysiologist | MD00046337 | WA |
N | 2084V0102X | Vascular Neurology | MD00046337 | WA |
NPI | 1295796647 |
---|---|
Provider Name | Laura M Lynam |
First Address | Tacoma, WA 98405-4261 |
Second Address | Tacoma, WA 98405-4261 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/03/2006 |
Last Update Date | 22/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
I33299 | (02) |