Provider Demographics
NPI:1528117405
Name:SPURLOCK, LYNN (PHD)
Entity type:Individual
Prefix:DR
First Name:LYNN
Middle Name:
Last Name:SPURLOCK
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2025 1ST AVE STE 720
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98121-3106
Mailing Address - Country:US
Mailing Address - Phone:206-728-2709
Mailing Address - Fax:206-448-6945
Practice Address - Street 1:2025 1ST AVE STE 720
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98121-3106
Practice Address - Country:US
Practice Address - Phone:206-728-2709
Practice Address - Fax:206-448-6945
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00001288103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling