Healthcare Provider Details

I. General information

NPI: 1255364261
Provider Name (Legal Business Name): LYNNE A HASPEDIS D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

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

III. Provider practice location address

220 W MERCER ST STE 110
SEATTLE WA
98119-3954
US

IV. Provider business mailing address

220 W MERCER ST STE 110
SEATTLE WA
98119-3954
US

V. Phone/Fax

Practice location:
  • Phone: 206-781-1830
  • Fax: 206-283-3640
Mailing address:
  • Phone: 206-781-1830
  • Fax: 206-283-3640

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License NumberOP00001184
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: