Healthcare Provider Details

I. General information

NPI: 1508055435
Provider Name (Legal Business Name): LYNN MARIE OKITA ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/16/2007
Last Update Date: 06/18/2021
Certification Date: 06/18/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 LILLY RD NE STE 250
OLYMPIA WA
98506
US

IV. Provider business mailing address

PO BOX 3360
PORTLAND OR
97208-3360
US

V. Phone/Fax

Practice location:
  • Phone: 360-493-5255
  • Fax: 360-493-4777
Mailing address:
  • Phone: 360-486-0617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License NumberAP30007796
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: