Provider Demographics
NPI:1295892032
Name:PANG, LYNETTE ANN (MA, LMHC)
Entity type:Individual
Prefix:MS
First Name:LYNETTE
Middle Name:ANN
Last Name:PANG
Suffix:
Gender:F
Credentials:MA, LMHC
Other - Prefix:
Other - First Name:LYNETTE
Other - Middle Name:ANN
Other - Last Name:BARN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:2366 EASTLAKE AVE E STE 312
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98102-3399
Mailing Address - Country:US
Mailing Address - Phone:206-251-6359
Mailing Address - Fax:
Practice Address - Street 1:2366 EASTLAKE AVE E STE 312
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3399
Practice Address - Country:US
Practice Address - Phone:206-251-6359
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-02
Last Update Date:2023-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALH00009904101YM0800X, 101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health