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General NPI Number Information
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NPI Number | 1053949735
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Entity Type | Individual
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Provider Name | ANDREA MARIE LYNDE DO
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Gender | Female
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Dates
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Enumeration Date | 03/30/2020
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 9230 SKY ISLAND DR E FL 2
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City | BONNEY LAKE
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State | WA
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Zip | 98391-7385
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Country | US
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Telephone | 253-750-6000
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Fax | 253-750-6100
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Provider Business Mailing Address
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Address Line | 9230 SKY ISLAND DR E FL 2
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City | BONNEY LAKE
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State | WA
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Zip | 98391-7385
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Country | US
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Telephone | 253-750-6000
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Fax | 253-750-6100
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | OP61688997
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License Number State | WA
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