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Individual

MRS. GLEE LYON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
ARNP

Contact information

Practice address
1919 70TH AVE W STE D1, UNIVERSITY PLACE, WA 98466-5541
(253) 565-7596
(253) 999-3323
Mailing address
1919 70TH AVE W STE D1, UNIVERSITY PLACE, WA 98466-5541
(253) 565-7596
(253) 999-3323

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
AP30001324
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
500015230
RAILROAD MEDICARE
WA
05
9605072
WA
Enumeration date
07/07/2005
Last updated
04/26/2018
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