Basic Information
| Provider Information | |||||||||
| NPI: | 1871965889 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | THAYRICH | ||||||||
| FirstName: | LYNN | ||||||||
| MiddleName: | |||||||||
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| Credential: | MA, LMHC, MHP | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 34703 | ||||||||
| Address2: | |||||||||
| City: | SEATTLE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 981241703 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2067640502 | ||||||||
| FaxNumber: | 2067640516 | ||||||||
| Practice Location | |||||||||
| Address1: | 2121 S 19TH ST | ||||||||
| Address2: | |||||||||
| City: | TACOMA | ||||||||
| State: | WA | ||||||||
| PostalCode: | 984052922 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2533961634 | ||||||||
| FaxNumber: | 2533961663 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 10/29/2015 | ||||||||
| LastUpdateDate: | 03/17/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YM0800X | MC 60451983 | WA | N | Behavioral Health & Social Service Providers | Counselor | Mental Health | 101YM0800X | LH60730109 | WA | Y | Behavioral Health & Social Service Providers | Counselor | Mental Health |
No ID Information.