Provider Demographics
NPI:1730474388
Name:PALMER, LYNNETTE ELIVRA
Entity type:Individual
Prefix:MISS
First Name:LYNNETTE
Middle Name:ELIVRA
Last Name:PALMER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4303 214TH ST SW
Mailing Address - Street 2:APT. B
Mailing Address - City:MOUNTLAKE TERRACE
Mailing Address - State:WA
Mailing Address - Zip Code:98043-3551
Mailing Address - Country:US
Mailing Address - Phone:509-209-4585
Mailing Address - Fax:
Practice Address - Street 1:4303 214TH ST SW
Practice Address - Street 2:APT. B
Practice Address - City:MOUNTLAKE TERRACE
Practice Address - State:WA
Practice Address - Zip Code:98043-3551
Practice Address - Country:US
Practice Address - Phone:509-209-4585
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-12
Last Update Date:2011-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health