Individual
MICHAEL LYCAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
8217 17TH ST SE, LAKE STEVENS, WA 98258-3839
(503) 930-1828
Mailing address
8217 17TH ST SE, LAKE STEVENS, WA 98258-3839
(503) 930-1828
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
A160711532
WA
Other
Enumeration date
05/19/2021
Last updated
05/19/2021
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