Healthcare Provider Details

I. General information

NPI: 1205507886
Provider Name (Legal Business Name): JAMES LEE PT, DPT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/23/2021
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date: 08/12/2026
Reactivation Date: 08/21/2026

III. Provider practice location address

527 MAIN ST
EAST GREENWICH RI
02818-3645
US

IV. Provider business mailing address

950 HARRINGTON AVE NE APT S409
RENTON WA
98056-3479
US

V. Phone/Fax

Practice location:
  • Phone: 401-471-7357
  • Fax:
Mailing address:
  • Phone: 425-999-6608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT.PT.61166246
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: