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Individual

JONATHAN AVERY LYON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPT, CSCS

Contact information

Practice address
3200 W. MCGRAW STREET, SEATTLE, WA 98199
(206) 281-7970
(425) 746-2471
Mailing address
1560 140TH AVENUE NE, SUITE 100, BELLEVUE, WA 98005
(425) 746-2475
(425) 746-2471

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT60146373
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0280803
DEPT. OF LABOR AND INDUSTRIES
WA
Enumeration date
05/13/2010
Last updated
12/05/2012
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