Individual
DR. LYNN LEROY STAKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
900 SHERIDAN MEDICAL CENTER, STE 105, BREMERTON, WA 98310-2701
(360) 479-0106
(360) 479-0107
Mailing address
900 SHERIDAN MEDICAL CENTER, STE 105, BREMERTON, WA 98310-2710
(360) 479-0106
(360) 479-0107
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
13918
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1835305
—
WA
01
—
191646800
OWCP
—
01
—
1J0545
KITSAP PHYSICIANS SERVICE
WA
Enumeration date
09/13/2006
Last updated
09/28/2010
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