MEDICARE: DR. LYNDON CLARENCE CAPON ARNP, ND, RN

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	163W00000X	Registered Nurse	RN00112784	WA
2	175F00000X	Naturopath	NT00000478	WA
3	363LF0000X	Family Nurse Practitioner	AP30006112	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0347193	OTHER	WA	LABOR & INDUSTRIES
2	0192446	OTHER	WA	STATE DEPT OF L & I

General Provider Information

NPI Number	:	1821083056
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LYNDON CLARENCE CAPON ARNP, ND, RN

Provider Business Mailing Address
First Line	:	11722 TULARE WAY W.
Second Line	:	MARYSVILLE
City	:	MARYSVILLE
State	:	WA
Zip	:	98271
Country	:	US
Telephone Number	:	425-280-2848
Fax Number	:	434-322-4336

Provider Business Practice Location Address
First Line	:	415 N OLYMPIC AVE
Second Line	:
City	:	ARLINGTON
State	:	WA
Zip	:	98223-1244
Country	:	US
Telephone Number	:	425-280-2802
Fax Number	:	434-322-4336

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

Provider Enumeration Date	:	09/14/2005
Last Update Date	:	06/06/2022

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