Individual
CHAN LY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
141 LILLY RD NE, OLYMPIA, WA 98506-5028
(360) 413-8880
(360) 810-3697
Mailing address
PO BOX 749495, ATLANTA, GA 30374-9495
(855) 963-2100
(813) 321-1296
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
RN60240413
WA
363L00000X
Nurse Practitioner
Primary
AP61214320
WA
Other
Enumeration date
03/26/2020
Last updated
09/11/2024
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