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General NPI Number Information
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NPI Number | 1881856680
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Entity Type | Individual
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Provider Name | LYNNE ABIGAIL TAN M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/02/2008
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Last Update Date | 07/02/2008
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Provider Practice Location Address
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Address Line | 550 16TH AVE SUITE #100
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City | SEATTLE
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State | WA
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Zip | 98122-5699
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Country | US
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Telephone | 206-320-3233
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 QUEEN ANNE AVE N APT 312
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City | SEATTLE
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State | WA
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Zip | 98109-3273
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Country | US
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Telephone | 407-765-3165
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Fax |
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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 | ML 60021929
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License Number State | WA
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