Provider Demographics
NPI:1427436260
Name:LYNCH RING, KELLY ANN (LMP, RF)
Entity type:Individual
Prefix:
First Name:KELLY
Middle Name:ANN
Last Name:LYNCH RING
Suffix:
Gender:F
Credentials:LMP, RF
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1420 ROOSEVELT AVE
Mailing Address - Street 2:#7
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-2687
Mailing Address - Country:US
Mailing Address - Phone:360-840-6013
Mailing Address - Fax:
Practice Address - Street 1:1420 ROOSEVELT AVE
Practice Address - Street 2:#7
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-2687
Practice Address - Country:US
Practice Address - Phone:360-840-6013
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-13
Last Update Date:2015-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00011585172M00000X
WARF60491354173C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172M00000XOther Service ProvidersMechanotherapist
No173C00000XOther Service ProvidersReflexologist