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NPI Code Detail

MEDICARE: MARY E LYONS PA-C

MEDICARE: MARY E LYONS PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA61157127WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1487314159
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARY E LYONS PA-C
Provider Business Mailing Address
First Line : 501 S 5TH AVE
Second Line :
City : YAKIMA
State : WA
Zip : 98902-3550
Country : US
Telephone Number : 509-853-1082
Fax Number : 509-573-6275
Provider Business Practice Location Address
First Line : 102 E 2ND ST
Second Line :
City : NACHES
State : WA
Zip : 98937-9743
Country : US
Telephone Number : 509-653-2235
Fax Number : 509-452-5224
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/22/2021
Last Update Date : 06/18/2024

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Directions to “ MARY E LYONS PA-C” Practice Location

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