Healthcare Provider Details

I. General information

NPI: 1811989940
Provider Name (Legal Business Name): LYNN MARIE MCCLATCHEY ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNN MARIE HUDSON ARNP

II. Dates (important events)

Enumeration Date: 08/16/2005
Last Update Date: 11/29/2022
Certification Date: 11/29/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

920 N WASHINGTON ST STE 200
SPOKANE WA
99201-2229
US

IV. Provider business mailing address

PO BOX 421
LIBERTY LAKE WA
99019-0421
US

V. Phone/Fax

Practice location:
  • Phone: 509-252-4200
  • Fax: 509-252-4201
Mailing address:
  • Phone: 866-747-2455
  • Fax: 509-227-7070

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAP30003390
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: