MEDICARE: HUI-YING THERESA LESAGE MD

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	207Q00000X	Family Medicine Physician	MD00034049	WA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3976LE	OTHER	WA	REGENCE
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598716144
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUI-YING THERESA LESAGE MD

Provider Business Mailing Address
First Line	:	873 HINOTES CT
Second Line	:	SUITE 1
City	:	LYNDEN
State	:	WA
Zip	:	98264-9043
Country	:	US
Telephone Number	:	360-318-9705
Fax Number	:	360-318-8735

Provider Business Practice Location Address
First Line	:	2075 BARKLEY BLVD
Second Line	:	SUITE 105
City	:	BELLINGHAM
State	:	WA
Zip	:	98226-6614
Country	:	US
Telephone Number	:	360-671-3345
Fax Number	:	360-650-1354

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

Provider Enumeration Date	:	05/16/2006
Last Update Date	:	11/09/2007

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