Provider Demographics
NPI:1285987644
Name:SHATZ, LYNN (LYNN SHATZ)
Entity type:Individual
Prefix:MS
First Name:LYNN
Middle Name:
Last Name:SHATZ
Suffix:
Gender:F
Credentials:LYNN SHATZ
Other - Prefix:MS
Other - First Name:LYNN
Other - Middle Name:
Other - Last Name:SHATZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LYNN SHATZ
Mailing Address - Street 1:10708 206TH ST SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98296-4924
Mailing Address - Country:US
Mailing Address - Phone:425-299-7211
Mailing Address - Fax:
Practice Address - Street 1:10708 206TH ST SE
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98296-4924
Practice Address - Country:US
Practice Address - Phone:425-299-7211
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-23
Last Update Date:2012-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADH00000888124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist