Provider Demographics
NPI:1477983732
Name:LYON, TANYA M (LMHC)
Entity Type:Individual
Prefix:
First Name:TANYA
Middle Name:M
Last Name:LYON
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:TANYA
Other - Middle Name:M
Other - Last Name:BUERGER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3435 MARTIN WAY E
Mailing Address - Street 2:SUITE E
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5071
Mailing Address - Country:US
Mailing Address - Phone:360-701-6980
Mailing Address - Fax:
Practice Address - Street 1:3435 MARTIN WAY E
Practice Address - Street 2:SUITE E
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5071
Practice Address - Country:US
Practice Address - Phone:360-701-6980
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-22
Last Update Date:2015-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60425708106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist