=====================================================
General NPI Number Information
=====================================================
NPI Number | 1831620541
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DAVID F. FLYNN, MD, PC
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/23/2017
-----------------------------------------------------
Last Update Date | 01/18/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 2743 CALIFORNIA AVE SW UNIT 100
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98116-2495
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 206-656-9615
-----------------------------------------------------
Fax | 206-656-3154
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | PO BOX 16160
-----------------------------------------------------
City | SEATTLE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98116-0160
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 508-450-6320
-----------------------------------------------------
Fax | 206-656-3154
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | OWNER
-----------------------------------------------------
Name | DAVID F FLYNN
-----------------------------------------------------
Credential | MD
-----------------------------------------------------
Telephone | 206-656-9615
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2084P0800X
-----------------------------------------------------
Taxonomy Name | Psychiatry Physician
-----------------------------------------------------
License Number | 231190
-----------------------------------------------------
License Number State | MA
-----------------------------------------------------