Provider Demographics
NPI:1033513643
Name:LYE, CHELSEA E
Entity type:Individual
Prefix:
First Name:CHELSEA
Middle Name:E
Last Name:LYE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 65345
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98464-1345
Mailing Address - Country:US
Mailing Address - Phone:206-312-7426
Mailing Address - Fax:206-302-2210
Practice Address - Street 1:12220 113TH AVE NE
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98034-6915
Practice Address - Country:US
Practice Address - Phone:206-312-7426
Practice Address - Fax:206-339-1550
Is Sole Proprietor?:No
Enumeration Date:2014-10-13
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALF60802092106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist