Provider Demographics
NPI:1528105764
Name:BAMBERGER, LYNN (DC)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:BAMBERGER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 100TH ST SW
Mailing Address - Street 2:SUITE B-201
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-2722
Mailing Address - Country:US
Mailing Address - Phone:425-355-4176
Mailing Address - Fax:
Practice Address - Street 1:215 100TH ST SW
Practice Address - Street 2:SUITE B-201
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204-2722
Practice Address - Country:US
Practice Address - Phone:425-355-4176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA2948111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor