Provider Demographics
NPI:1386698108
Name:MYERS, LANE ALAN (MSW)
Entity type:Individual
Prefix:MR
First Name:LANE
Middle Name:ALAN
Last Name:MYERS
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1044 151ST AVE SE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98007-5815
Mailing Address - Country:US
Mailing Address - Phone:425-641-4094
Mailing Address - Fax:206-764-2514
Practice Address - Street 1:DEPARTMENT OF VETERANS AFFAIRS
Practice Address - Street 2:1660 SOUTH COLUMBIAN WAY
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108
Practice Address - Country:US
Practice Address - Phone:206-764-2418
Practice Address - Fax:206-764-2514
Is Sole Proprietor?:No
Enumeration Date:2006-05-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW000044141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical