Provider Demographics
NPI:1427829472
Name:LYONS, ALISON NICOLE VEAL (MA 61508759)
Entity type:Individual
Prefix:
First Name:ALISON
Middle Name:NICOLE VEAL
Last Name:LYONS
Suffix:
Gender:F
Credentials:MA 61508759
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1008 SW 150TH ST APT B
Mailing Address - Street 2:
Mailing Address - City:BURIEN
Mailing Address - State:WA
Mailing Address - Zip Code:98166-1854
Mailing Address - Country:US
Mailing Address - Phone:206-399-6643
Mailing Address - Fax:
Practice Address - Street 1:612 SW 152ND ST
Practice Address - Street 2:
Practice Address - City:BURIEN
Practice Address - State:WA
Practice Address - Zip Code:98166-2213
Practice Address - Country:US
Practice Address - Phone:206-244-1466
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA61508759225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist