Individual
LYNETTE CHRISTINE SPJUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1111 NE 99TH AVE STE 200, PORTLAND, OR 97220-9442
(503) 963-3030
(503) 963-3140
Mailing address
541 NE 20TH AVE STE 225, PORTLAND, OR 97232-2895
(503) 963-2801
(503) 963-2825
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA60072217
WA
363AM0700X
Medical Physician Assistant
Primary
PA01462
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1962694976
—
WA
05
—
500607345
—
OR
Enumeration date
08/14/2007
Last updated
11/21/2023
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