Healthcare Provider Details

I. General information

NPI: 1912835448
Provider Name (Legal Business Name): YOUNG JU LEE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DIANNE LEE RPH

II. Dates (important events)

Enumeration Date: 05/13/2026
Last Update Date: 05/13/2026
Certification Date: 05/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 WINTERGREEN LN NE
BAINBRIDGE ISLAND WA
98110-5118
US

IV. Provider business mailing address

1120 8TH AVE APT 1502
SEATTLE WA
98101-2568
US

V. Phone/Fax

Practice location:
  • Phone: 206-317-8521
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHRM.PH.70024640
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: