Healthcare Provider Details

I. General information

NPI: 1346325982
Provider Name (Legal Business Name): LEE E PRICE DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 12/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11711 NE 12TH ST STE 3A
BELLEVUE WA
98005-2461
US

IV. Provider business mailing address

PO BOX 50646
BELLEVUE WA
98015-4072
US

V. Phone/Fax

Practice location:
  • Phone: 425-454-1405
  • Fax: 425-452-0667
Mailing address:
  • Phone: 425-454-6936
  • Fax: 425-452-0667

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1921
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: