Provider Demographics
NPI:1871965889
Name:THAYRICH, LYNN (MA, LMHC, MHP)
Entity type:Individual
Prefix:
First Name:LYNN
Middle Name:
Last Name:THAYRICH
Suffix:
Gender:F
Credentials:MA, LMHC, MHP
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 34703
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1703
Mailing Address - Country:US
Mailing Address - Phone:206-764-0502
Mailing Address - Fax:206-764-0516
Practice Address - Street 1:2121 S 19TH ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98405-2922
Practice Address - Country:US
Practice Address - Phone:253-396-1634
Practice Address - Fax:253-396-1663
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-29
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC 60451983101YM0800X
WALH60730109101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health