Active NPI
Glee Lyon, ARNP
- Psychiatric/Mental Health Nurse Practitioner
- University Place, WA
National Provider Identifier
1184621831
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner
- License
- AP30001324
- Practice address
- 1919 70TH Ave W Ste D1
University Place, WA 98466-5541 - Phone
- (253) 565-7596
- Fax
- (253) 999-3323
- NPI assigned
- Jul 7, 2005
- Last updated
- Apr 26, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | AP30001324 | WA | Primary |
Addresses
Primary practice location
1919 70TH Ave W Ste D1
University Place, WA 98466-5541
Mailing address
1919 70TH Ave W Ste D1
University Place, WA 98466-5541
Phone (253) 565-7596
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 9605072 | Medicaid | WA | |
| 500015230 | Other | WA | RAILROAD MEDICARE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Silvia Fradkin Arnp PS | Single Specialty | Past | Accepting new patients |
| Deborah L. Hickey, D.O.PS | Single Specialty | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Psychiatric/Mental Health Nurse Practitioner
- Fircrest, WA
- NPI 1558401687
Single Specialty
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1120694400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1524700800000",
"number": "1184621831",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1919 70TH AVE W STE D1",
"city": "UNIVERSITY PLACE",
"state": "WA",
"postal_code": "984665541",
"telephone_number": "253-565-7596",
"fax_number": "253-999-3323"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1919 70TH AVE W STE D1",
"city": "UNIVERSITY PLACE",
"state": "WA",
"postal_code": "984665541",
"telephone_number": "253-565-7596",
"fax_number": "253-999-3323"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LYON",
"first_name": "GLEE",
"name_prefix": "Mrs.",
"credential": "ARNP",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2005-07-07",
"last_updated": "2018-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "363LP0808X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Psychiatric/Mental Health",
"state": "WA",
"license": "AP30001324",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "9605072",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "500015230",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in University Place, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.