Healthcare Provider Details

I. General information

NPI: 1881628048
Provider Name (Legal Business Name): LYNNE E SCHMIDTKE CNM, ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2006
Last Update Date: 06/25/2021
Certification Date: 06/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 LILLY RD NE
OLYMPIA WA
98506-5115
US

IV. Provider business mailing address

3920 CAPITAL MALL DR. SUITE 400
OLYMPIA WA
98502
US

V. Phone/Fax

Practice location:
  • Phone: 360-923-7000
  • Fax:
Mailing address:
  • Phone: 360-705-1259
  • Fax: 360-705-2757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberAP30004183
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: