Active NPI
Jordan Alix Lyon, PH.D.
- Cognitive & Behavioral Psychologist
- Seattle, WA
National Provider Identifier
1164748307
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Cognitive & Behavioral Psychologist
- License
- PY60075349
- Practice address
- 1200 5TH Ave
Suite 800
Seattle, WA 98101-3132 - Phone
- (206) 374-0109
- Fax
- (206) 374-0108
- NPI assigned
- Apr 13, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Cognitive & Behavioral Psychologist | 103TB0200X | PY60075349 | WA | Primary |
Addresses
Primary practice location
1200 5TH Ave
Suite 800
Seattle, WA 98101-3132
Mailing address
1200 5TH Ave
Suite 800
Seattle, WA 98101-3132
Phone (206) 374-0109
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
- Opted out of Medicare
- Yes, effective Jan 1, 2017 through Jan 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PY60075349 | WA | MD | Cognitive & Behavioral Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1271116800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1271116800000",
"number": "1164748307",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1200 5TH AVE",
"address_2": "SUITE 800",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981013132",
"telephone_number": "206-374-0109",
"fax_number": "206-374-0108"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1200 5TH AVE",
"address_2": "SUITE 800",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981013132",
"telephone_number": "206-374-0109",
"fax_number": "206-374-0108"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYON",
"first_name": "JORDAN",
"middle_name": "ALIX",
"credential": "PH.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-04-13",
"last_updated": "2010-04-13",
"status": "A"
},
"taxonomies": [
{
"code": "103TB0200X",
"taxonomy_group": "",
"desc": "Psychologist, Cognitive & Behavioral",
"state": "WA",
"license": "PY60075349",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.