MEDICARE: JOSEPHINE LYNN LUNDGREN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	106S00000X	Behavior Technician

General Provider Information

NPI Number	:	1881549301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPHINE LYNN LUNDGREN

Provider Business Mailing Address
First Line	:	3213 W WHEELER ST STE 302
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98199-3245
Country	:	US
Telephone Number	:	206-453-4882
Fax Number	:	206-453-5094

Provider Business Practice Location Address
First Line	:	3213 W WHEELER ST STE 302
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98199-3245
Country	:	US
Telephone Number	:	206-453-4882
Fax Number	:	206-453-5094

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/02/2026
Last Update Date	:	03/02/2026

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Directions to “ JOSEPHINE LYNN LUNDGREN ” Practice Location

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