NPIMap

Individual provider Active NPI

Lynda Brady Stafford, DO

  • Family Medicine Physician
  • Montesano, WA
National Provider Identifier
1629021852
Registry record updated Aug 13, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
OP00002036 Issued in WA
Practice address
319 E Pioneer Ave
Montesano, WA 98563-4601
Phone
(360) 249-3300
NPI assigned
May 18, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X OP00002036 WA Primary

Addresses

Primary practice location

319 E Pioneer Ave
Montesano, WA 98563-4601

Mailing address

4001 Harrison Ave NW
Ste 101
Olympia, WA 98502-5084
Phone (360) 704-2362

Other practice location 1

4001 Harrison Ave NW
Ste 101
Olympia, WA 98502-5084
Phone (360) 704-2362

Other identifiers 1

IdentifierTypeStateIssuer
8449522MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060522000005 WA Practitioner - Family Practice 9032120472 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of North Texas HSC, College of Osteopathic Med, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Providence Health and Services WashingtonGroup PAC ID 6709782600, 480 clinicians
Pershing General HospitalGroup PAC ID 7012825433, shared by 4 NPIs, 13 clinicians

Practice addresses (Care Compare)

1450 Northwest LN SE
Suite a
Lacey, WA 98503-6908
Phone (360) 491-4460

PO Box
Suite 661
Lovelock, NV 89419-0661

Hospital & facility affiliations

  • Assured Home Health and Hospice Home health agency, Centralia, WA, CCN 507042
  • Careage Home Health Home health agency, Dupont, WA, CCN 507129
  • Providence Centralia Hospital Hospital, Centralia, WA, CCN 500019
  • Providence St Peter Hospital Hospital, Olympia, WA, CCN 500024
  • Pershing General Hospital Hospital, Lovelock, NV, CCN 291304
  • Humboldt General Hospital Hospital, Winnemucca, NV, CCN 291308
  • Banner Churchill Community Hospital Hospital, Fallon, NV, CCN 291313
  • Panorama City Conv & Rehab Ctr Nursing home, Lacey, WA, CCN 505059

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of skin lesions1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
OP00002036WAMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince May 31, 2023 Accepting new patients
Grays Harbor Community Hospital CurrentSince Apr 1, 2021 Accepting new patients
Providence Health & Services Washington Family Medicine CurrentSince May 31, 2023 Accepting new patients
Grays Harbor Community Hospital CurrentSince Apr 1, 2021 Accepting new patients

Locations

915 Anderson Dr
Aberdeen, WA 98520
Phone (360) 532-8330

1006 N H St
Aberdeen, WA 98520
Phone (360) 537-6032

1450 Northwest Ln SE
Ste A
Lacey, WA 98503
Phone (360) 491-4227

8645 Martin Way E
Lacey, WA 98516
Phone (360) 515-0070

319 E Pioneer Ave
Montesano, WA 98563
Phone (360) 249-1980

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

3425 Ensign Rd NE
Ste 220
Olympia, WA 98506
Phone (360) 491-1112

Interoperability endpoints

  • Direct secure messaging: lstafford2831614@wm.providencedirect.org

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 10

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628812800000",
    "number": "1629021852",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4001 HARRISON AVE NW",
            "address_2": "STE 101",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025084",
            "telephone_number": "360-704-2362",
            "fax_number": "360-350-1445"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "319 E PIONEER AVE",
            "city": "MONTESANO",
            "state": "WA",
            "postal_code": "985634601",
            "telephone_number": "360-249-3300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4001 Harrison Ave NW",
            "address_2": "STE 101",
            "address_purpose": "LOCATION",
            "city": "Olympia",
            "state": "WA",
            "postal_code": "985025084",
            "country_code": "US",
            "telephone_number": "360-704-2362",
            "fax_number": "360-350-1445",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "STAFFORD",
        "first_name": "LYNDA",
        "middle_name": "BRADY",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-18",
        "last_updated": "2021-08-13",
        "certification_date": "2021-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "OP00002036",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8449522",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Montesano, WA

Sources for this page

Verify at the official NPI Registry.