Basic Information
Provider Information | |||||||||
NPI: | 1083682694 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | LYNCH | ||||||||
FirstName: | PATRICK | ||||||||
MiddleName: | S | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: | JR. | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 601 W 5TH AVE | ||||||||
Address2: | SUITE 400 | ||||||||
City: | SPOKANE | ||||||||
State: | WA | ||||||||
PostalCode: | 992042715 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5093442663 | ||||||||
FaxNumber: | 5096249179 | ||||||||
Practice Location | |||||||||
Address1: | 601 W 5TH AVE | ||||||||
Address2: | SUITE 400 | ||||||||
City: | SPOKANE | ||||||||
State: | WA | ||||||||
PostalCode: | 992042715 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5093442663 | ||||||||
FaxNumber: | 5096249179 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 03/09/2006 | ||||||||
LastUpdateDate: | 08/04/2011 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | MD00027710 | WA | Y |   | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |   |
ID Information
ID | Type | State | Issuer | Description | 003792000 | 05 | ID |   | MEDICAID | KQ555 | 01 | ID | BLUE CROSS OF ID | OTHER | 149067 | 01 | WA | DEPT OF LABOR & INDUSTRIE | OTHER | 8164 | 01 | WA | GROUP HEALTH NW | OTHER | 1080LY | 01 | WA | ASURIS NW HEALTH | OTHER | 8929874 | 01 | WA | CRIME VICTIMS | OTHER | 200040945 | 01 | WA | RR MEDICARE | OTHER | 275261 | 05 | OR |   | MEDICAID | 379109600 | 01 | WA | OWCP | OTHER | 8118457 | 05 | WA |   | MEDICAID | 000010000662 | 01 | ID | REGENCE BLUE SHIELD OF ID | OTHER | 0035887 | 05 | MT |   | MEDICAID |