Healthcare Provider Details

I. General information

NPI: 1962827915
Provider Name (Legal Business Name): MIJUNG LEE M.AC., L.AC.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/27/2014
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9020 OLD GEORGETOWN RD
BETHESDA MD
20814-1514
US

IV. Provider business mailing address

5800 MIDHILL ST
BETHESDA MD
20817-6173
US

V. Phone/Fax

Practice location:
  • Phone: 202-802-5225
  • Fax:
Mailing address:
  • Phone: 202-802-5225
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberU02100
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: