Healthcare Provider Details

I. General information

NPI: 1396724258
Provider Name (Legal Business Name): TIMOTHY W. LYNCH PHARM D
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34515 9TH AVE S
FEDERAL WAY WA
98003-6761
US

IV. Provider business mailing address

4408 36TH AVE NE
TACOMA WA
98422-2629
US

V. Phone/Fax

Practice location:
  • Phone: 253-944-4142
  • Fax:
Mailing address:
  • Phone: 253-944-4142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00020731
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: