Individual
KENNETH ROBERT LYONS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS, SUDP
Contact information
Practice address
3639 MLK JR WAY S, SEATTLE, WA 98144
(206) 805-8972
Mailing address
3639 MLK JR WAY SOUTH, SEATTLE, WA 98144
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
CG60475258
WA
101Y00000X
Counselor
CO60906258
WA
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP61249696
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2110425
—
WA
Enumeration date
06/15/2017
Last updated
06/29/2023
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