Provider Demographics
NPI:1811989940
Name:MCCLATCHEY, LYNN MARIE (ARNP)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:MARIE
Last Name:MCCLATCHEY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:LYNN
Other - Middle Name:MARIE
Other - Last Name:HUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 421
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-0421
Mailing Address - Country:US
Mailing Address - Phone:866-747-2455
Mailing Address - Fax:509-227-7070
Practice Address - Street 1:920 N WASHINGTON ST STE 200
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99201-2229
Practice Address - Country:US
Practice Address - Phone:509-252-4200
Practice Address - Fax:509-252-4201
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2022-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30003390363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAA012OtherTRIWEST
WA7781511OtherAETNA
WA1019684Medicaid
ID805081300Medicaid