Individual
JILL LAVERNE LYON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CDPT
Contact information
Practice address
1230 MONITOR ST, WENATCHEE, WA 98801-3534
(509) 232-5766
(509) 321-5472
Mailing address
12715 E MISSION AVE, SPOKANE VALLEY, WA 99216-1027
(509) 232-5766
(509) 321-5472
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO60572125
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2077844
—
WA
Enumeration date
06/28/2019
Last updated
06/28/2019
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