Healthcare Provider Details

I. General information

NPI: 1720323827
Provider Name (Legal Business Name): LYNNE M OLIPHANT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/30/2012
Last Update Date: 11/30/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5511 15TH AVE S
SEATTLE WA
98108-2823
US

IV. Provider business mailing address

5511 15TH AVE S
SEATTLE WA
98108-2823
US

V. Phone/Fax

Practice location:
  • Phone: 206-252-7807
  • Fax: 206-252-7801
Mailing address:
  • Phone: 206-252-7807
  • Fax: 206-252-7801

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN00086318
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: