Healthcare Provider Details

I. General information

NPI: 1265679013
Provider Name (Legal Business Name): CITY OF LYNNWOOD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/15/2009
Last Update Date: 05/21/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19321 44TH AVE W
LYNWOOD WA
98036-5664
US

IV. Provider business mailing address

19321 44TH AVE W
LYNWOOD WA
98036-5664
US

V. Phone/Fax

Practice location:
  • Phone: 425-670-5648
  • Fax: 425-771-0122
Mailing address:
  • Phone: 425-670-5648
  • Fax: 425-771-0122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QP2400X
TaxonomyPrison Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. COLEMAN LANGDON
Title or Position: CHIEF OF POLICE
Credential:
Phone: 425-670-5601