MEDICARE: LYNNE CLAIRE WALSH ARNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LP1700X	Perinatal Nurse Practitioner	AP30008020	WA
2	363LA2200X	Adult Health Nurse Practitioner	AP30008020	WA
3	363LW0102X	Women's Health Nurse Practitioner	AP30008020	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	AP30008020	OTHER	WA	WA ARNP LICENSE

General Provider Information

NPI Number	:	1447437272
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LYNNE CLAIRE WALSH ARNP

Provider Business Mailing Address
First Line	:	1110 112TH AVE NE
Second Line	:	SUITE 100
City	:	BELLEVUE
State	:	WA
Zip	:	98004-4509
Country	:	US
Telephone Number	:	425-749-3324
Fax Number	:	425-688-8110

Provider Business Practice Location Address
First Line	:	1110 112TH AVE NE
Second Line	:	SUITE 100
City	:	BELLEVUE
State	:	WA
Zip	:	98004-4509
Country	:	US
Telephone Number	:	425-749-3324
Fax Number	:	425-688-8110

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/23/2008
Last Update Date	:	02/15/2011

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