MEDICARE: MEGAN LEE

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	2084P0800X	Psychiatry Physician	MD.MD.61566054	WA

General Provider Information

NPI Number	:	1639811094
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MEGAN LEE

Provider Business Mailing Address
First Line	:	1550 NORTH 115TH STREET BOX 358828
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98133
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1550 NORTH 115TH STREET BOX 358828
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98133-0001
Country	:	US
Telephone Number	:	206-543-6577
Fax Number	:

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

Provider Enumeration Date	:	04/07/2022
Last Update Date	:	06/04/2026

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