Healthcare Provider Details

I. General information

NPI: 1033513643
Provider Name (Legal Business Name): CHELSEA E LYE
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/13/2014
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12220 113TH AVE NE
KIRKLAND WA
98034-6915
US

IV. Provider business mailing address

PO BOX 65345
TACOMA WA
98464-1345
US

V. Phone/Fax

Practice location:
  • Phone: 206-312-7426
  • Fax: 206-339-1550
Mailing address:
  • Phone: 206-312-7426
  • Fax: 206-302-2210

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberLF60802092
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: