Provider Demographics
NPI:1477278836
Name:LYNE, LILI
Entity Type:Individual
Prefix:
First Name:LILI
Middle Name:
Last Name:LYNE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:917 SW HOLDEN ST APT 302
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98106-2093
Mailing Address - Country:US
Mailing Address - Phone:248-798-6044
Mailing Address - Fax:
Practice Address - Street 1:402 S 333RD ST STE 130
Practice Address - Street 2:
Practice Address - City:FEDERAL WAY
Practice Address - State:WA
Practice Address - Zip Code:98003-6073
Practice Address - Country:US
Practice Address - Phone:206-567-7267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-07
Last Update Date:2022-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist