Healthcare Provider Details

I. General information

NPI: 1356984124
Provider Name (Legal Business Name): CATHERINE R LEE
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/23/2019
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 W BASELINE RD
TEMPE AZ
85283-1072
US

IV. Provider business mailing address

2700 W BASELINE RD
TEMPE AZ
85283-1072
US

V. Phone/Fax

Practice location:
  • Phone: 602-438-2807
  • Fax: 602-431-9592
Mailing address:
  • Phone: 602-549-6178
  • Fax: 602-431-9592

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberI023279
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: