Healthcare Provider Details

I. General information

NPI: 1225214927
Provider Name (Legal Business Name): LYNNE ELIZABETH WURZER FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: LYNNE ELIZABETH BETTLES FNP-C

II. Dates (important events)

Enumeration Date: 01/14/2008
Last Update Date: 06/05/2025
Certification Date: 06/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2420 S UNION AVE
TACOMA WA
98405-1322
US

IV. Provider business mailing address

1112 NEAH DR
FOX ISLAND WA
98333-9513
US

V. Phone/Fax

Practice location:
  • Phone: 253-302-9416
  • Fax:
Mailing address:
  • Phone: 253-525-7726
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201407669NP-PP
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: