Individual
ERIN M LYSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
916 PACIFIC AVE, EVERETT, WA 98201-4147
(425) 404-4000
Mailing address
2302 GRAND AVE, EVERETT, WA 98201-2714
(206) 571-6897
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
58323
CA
363A00000X
Physician Assistant
Primary
PA60310348
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0303950
L&I
WA
05
—
1730430380
—
WA
01
—
58323
MEDICAL LICENSE
CA
01
—
PA60310348
MEDICAL LICENSE
WA
Enumeration date
09/23/2012
Last updated
09/06/2022
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