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General NPI Number Information
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NPI Number | 1295936599
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Entity Type | Individual
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Provider Name | AGYNESS G LYON LMT CHT
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Gender | Female
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Dates
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Enumeration Date | 05/31/2007
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 922 MCGILVRA BLVD E
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City | SEATTLE
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State | WA
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Zip | 98112-5000
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Country | US
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Telephone | 206-324-3200
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Fax |
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Provider Business Mailing Address
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Address Line | 2117 S CUSHMAN AVE
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City | TACOMA
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State | WA
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Zip | 98405-3439
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Country | US
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Telephone | 206-866-8732
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 00006036
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License Number State | WA
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