Provider Demographics
NPI:1871786863
Name:MIKEL, LYNN T (ND)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:T
Last Name:MIKEL
Suffix:
Gender:F
Credentials:ND
Other - Prefix:MS
Other - First Name:LYNN
Other - Middle Name:T
Other - Last Name:MIKEL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:22015 MARINE VIEW DR S
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:WA
Mailing Address - Zip Code:98198-6222
Mailing Address - Country:US
Mailing Address - Phone:206-878-2628
Mailing Address - Fax:
Practice Address - Street 1:22015 MARINE VIEW DR S
Practice Address - Street 2:
Practice Address - City:DES MOINES
Practice Address - State:WA
Practice Address - Zip Code:98198-6222
Practice Address - Country:US
Practice Address - Phone:206-878-2628
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-22
Last Update Date:2007-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT00001180175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath