MEDICARE: MRS. ROBIN JILL LEE MA, LMHC,MHP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	CG60475236	WA
2	101YM0800X	Mental Health Counselor	LH60607283	WA

General Provider Information

NPI Number	:	1275944928
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROBIN JILL LEE MA, LMHC,MHP

Provider Business Mailing Address
First Line	:	304 SE HEARTWOOD BLVD
Second Line	:	UNIT 873932
City	:	VANCOUVER
State	:	WA
Zip	:	98687
Country	:	US
Telephone Number	:	360-861-4724
Fax Number	:	360-397-8494

Provider Business Practice Location Address
First Line	:	304 SE HEARTWOOD BLVD
Second Line	:	UNIT 873932
City	:	VANCOUVER
State	:	WA
Zip	:	98687
Country	:	US
Telephone Number	:	360-861-4724
Fax Number	:	360-397-8494

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/15/2014
Last Update Date	:	02/08/2021

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