Healthcare Provider Details

I. General information

NPI: 1396090080
Provider Name (Legal Business Name): PATRICIA J LYON MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/18/2012
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16000 BOTHELL EVERETT HWY STE 200
MILL CREEK WA
98012-1796
US

IV. Provider business mailing address

12726 NE 116TH LN APT E5
KIRKLAND WA
98034-8433
US

V. Phone/Fax

Practice location:
  • Phone: 425-736-7478
  • Fax:
Mailing address:
  • Phone: 425-736-7478
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH60867944
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberCP6369-R
License Number StateNV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: